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Weight loss due to on and off diarrhea, blood in stools, LLQ pain - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: IBS(Irritable Bowel Syndrome)
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
User :   What can cause unintentional weight loss of 80 pounds in the length of 12 months with diarrhea ,LLQ pain that radiates to the back and left testicle, normal CBC with Diff, Comp. Metabolic Panel, Lipid panel except high triglycerides (164), High Bilirubin (2.6, Gilber'ts), High LDL (104), Normal Thyroid Panet(TSH, T3, T4), PSA, Triiodothyronine, Amylase, Lipase, Cortisol, Hepatic Function Panel, Hepatitis Panel, HIV, RPR, clean Endoscopy with biospy to check for celiac and normal, A CT Scan of the abdomen, pelvis and chest, all normal, and scheduled for a colonoscopy this friday, i keep losing weight and no matter what i eat i keep losing. I am not taking any medications i am not on a diet, i weigh 171 when i used to weigh 250 a year ago. I am 5'9" and 32 years old. What do i do? i also have no insurance.
Doctor :   hi
Doctor :   Dr. XXXXXXXX here
User :   Hello
Doctor :   Please give me few moments to read what you have typed
User :   Ok, thank you
Doctor :   could please describe the LLQ pain in more detail?
Doctor :   please provide your gender
User :   It comes in waves, it is not constant, when it is worst it is a stabbing pain, when it is not as bad it is achy, though the pain does come and go, it has been bad for the past day
User :   Male
Doctor :   is there any mucus or blood or altered color that you have noticed in stools?
User :   A little bit lighter in coloring, and not having any solid stools for the past few months, I have had bright red blood in the toilet before, though not a large amount and not consitantly
Doctor :   do you have other symptoms associated like belching, burping, nausea, upper stomach discomfort, heartburn?
User :   No other symtptoms.
Doctor :   ok. how long back was this 'bright red blood in the toilet'? was it associated with passing stools?
User :   About a month ago, and it was after a bowel movement
Doctor :   do feel urgency for bowel movements?
User :   not really just a little more often
Doctor :   feeling of incomplete evacuation, bloating or abdominal distension?
User :   incomplete evacuation, still feel like I have to go
User :   but that also lets up
Doctor :   ok. do you have feelings of depression or anxiety over this last one year?
User :   nothing that has effected my appetite
User :   I have tried to gain weight by eating 3 to 5 thousand colories a day did not work
Doctor :   is there headache or any symptoms associated with passing of urine?
User :   no
Doctor :   ok
Doctor :   I would recommend you to go ahead with th scheduled colonoscopy, it will be done to rule out IBS (inflammatory bowel syndrome) since your symptoms are suggestive of IBS
Doctor :   once the cause is found out, treatment that is appropriate can be started to relieve your symptoms
User :   IBS can cause an 80 l;b weight loss
Doctor :   and once the diarrhea and symptoms are under control
Doctor :   then proper diet can be started to gain weight
Doctor :   sometimes it can cause weightloss, since it does not allow for proper absorption of nutrients
Doctor :   by affecting the mucosal lining which is responsible to absorb the essential nutrients from the food that you take
Doctor :   are you on any medications at present?
User :   No i am not
Doctor :   along with a colonoscopy, a bariem meal study will be recommended to look for chronic changes
Doctor :   have you followed what I have said?
User :   well they want to do a swallow study by having me swallow a camera if the colonoscopy comes back normal.
User :   yes
Doctor :   ok.
User :   what is barium meal study
Doctor :   then they too are suspecting presence of IBS
Doctor :   and they will try all tests to confirm/rule it out
Doctor :   barium meal study is a study in which radioactive substance (safe) is given to swallow and the serial x-rays taken to see progression and the
User :   I just have not read anywhere that it is within normal limits to lose 30% of your weight with IBS
Doctor :   filling defects that when the meal reaches the affected part of the bowel
Doctor :   your weight loss is severe i agree, but since all the other tests have come back normal, the weight can be attributed to this itself
Doctor :   did you follow what I have said?
User :   yeah im thinking
Doctor :   is there anything else I can help you with?
User :   is it possible for it to be something more serious
Doctor :   you can go through this link to know more about it
Doctor :   WWW.WWWW.WW
Doctor :   something more serious than IBS that involves severe weight loss could be cancer of bowel
User :   i feel like i need to see what all the options are because we are running at a dead end
User :   our GP and gastroenterologist does not think it is IBS they thought that until the weight just kept coming off and now it is starting to eat away my muscles, i have hd to
User :   get my rings sized i went down a whole ring size i went from a 38 waist to a 30, my muscles are getting smaller and i sometimes get so tired that i sleep all day then i have all the energy in the world the next.
Doctor :   ok. they have done almost all the tests on you with the results coming back normal
User :   yes and its frusterating
Doctor :   so the last option wold be the colonoscopy and barium meal study
Doctor :   if these also come back normal
User :   i need to find out whats wrong withh me
Doctor :   then it would be necessary to do tumor marker tests to find out if there are preliminary stages of bowel cancer
User :   the recommended possibly going to an endrocrinologist
User :   how likely is colon cancer for someone my age of 32?
Doctor :   yes, it would help, but there are no hormonal abnormalities, so this again is questionable how much an endocrinologist would be able to help
User :   i thought that happened when you got older or can younger people get it too
Doctor :   it is rare in age below 40
Doctor :   but it can still happen in all age groups in rare cases.
Doctor :   if there is family history of colon cancer, then it can occur as early as 20 years of age
Doctor :   for example, 1 hereditary condition, known as familial adenomatous polyposis, in this, patients develop hundreds of colon polyps at a very young age and colon cancer often appears before age 20, with classical symptoms of alternate diarrhea and constipation and weight loss
User :   with the symptoms im having would it be treatable or would this be bad
Doctor :   if detected , then the treatment and prognosis would depend on the stage of the problem
Doctor :   the earlier it is diagnosed, the better prognosis becomes
User :   its just scary watching myself melt away
Doctor :   since treatment can be started early
Doctor :   do not worry, focus on getting to the root cause
Doctor :   discuss about what I have discussed with your treated GP and gastroenterologist
Doctor :   there will be a way out
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