Weight Loss Due to Peptic Ulcers: Is PPI Use a Normal Factor?

Weight loss caused by peptic ulcers?

Hello Dr.
Ke, thank you for addressing my concerns regarding rectal bleeding.
Additionally, is it normal to experience weight loss when taking proton pump inhibitors (PPIs) for peptic ulcers? About six months ago (September 2015), my weight was approximately 78 kg.
After being diagnosed with a peptic ulcer in late October to early November, my weight gradually decreased by about 0.5 kg every week or two.
After starting PPIs in early January, my weight dropped more rapidly to around 75 kg.
After taking the medication for eight weeks and stopping on January 18, my weight continued to decline, reaching 73.5 kg today.
Given my previous symptoms of rectal bleeding, I am quite worried.
I would appreciate your insights on this matter.
Thank you!

Steven, 30~39 year old female. Ask Date: 2016/02/01

Dr. Ke Fangxu reply Surgery

The use of proton pump inhibitors (PPIs) for peptic ulcers does not cause weight loss; rather, it is more likely due to changes in dietary habits after being diagnosed with a peptic ulcer.
If there have been no changes in diet or exercise habits, it is important to first check blood glucose levels and thyroid function to rule out diabetes and hyperthyroidism, as these are the most common causes of weight loss.
If both are normal, further investigations should be conducted to identify potential issues.

Reply Date: 2016/02/01

More Info

Weight loss in patients with peptic ulcers can be concerning, and it is important to understand the potential factors contributing to this phenomenon. Proton Pump Inhibitors (PPIs) are commonly prescribed to manage peptic ulcers by reducing gastric acid production, which helps in healing the ulcer and alleviating symptoms. However, the relationship between PPI use and weight loss is not straightforward.

Firstly, it is essential to recognize that the weight loss you are experiencing may not be directly caused by the PPI itself. Instead, it could be a result of the underlying condition—peptic ulcers. When individuals suffer from ulcers, they may experience significant discomfort, pain, and changes in appetite. These symptoms can lead to a reduction in food intake, resulting in weight loss. Additionally, if there are complications such as gastrointestinal bleeding, as indicated by your previous symptoms of blood in the stool, this can further exacerbate weight loss due to nutrient malabsorption and increased metabolic demands from the body trying to heal.

Moreover, the psychological impact of being diagnosed with a peptic ulcer can also lead to changes in eating habits. Patients may avoid certain foods that they associate with exacerbating their symptoms, which can inadvertently lead to a caloric deficit and subsequent weight loss.
Regarding the timeline you provided, it is not uncommon for weight loss to occur gradually after the diagnosis of a peptic ulcer. The initial weight loss of about 0.5 kg per week could be attributed to dietary changes and the body's response to the ulcer. After starting PPI therapy, if you noticed a more rapid decline in weight, it could be due to a combination of factors, including continued dietary restrictions, the effects of the ulcer, and possibly the side effects of the medication itself.

PPIs are generally well-tolerated, but they can have side effects, including gastrointestinal discomfort, which might lead some patients to eat less. If you are experiencing abdominal discomfort or any other side effects while on PPIs, it is crucial to discuss these symptoms with your healthcare provider. They may need to evaluate whether the PPI is the right medication for you or if adjustments are necessary.

In terms of monitoring your weight and overall health, it is advisable to keep track of your weight regularly and report any significant changes to your doctor. If your weight continues to decline or if you experience other concerning symptoms, further evaluation may be warranted. This could include blood tests to check for anemia, thyroid function tests, and possibly imaging studies or endoscopy to assess the status of your ulcer and rule out any complications.

In conclusion, while PPI use is not typically associated with weight loss, the underlying condition of peptic ulcers and associated symptoms can lead to changes in appetite and weight. It is essential to maintain open communication with your healthcare provider regarding your symptoms and any concerns about weight loss, as they can help guide you through appropriate management strategies to ensure your health and well-being.

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