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Suggest treatment for pain in stomach and drastic weight loss

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Posted on Fri, 30 Jan 2015
Question: Hi doctor this is XXXXXXX my mother is having pain in her stomach from past 7 to 8 months we did all the possible test CT scan, angiography of stomach but doctors are saying all the reports are normal cannot find she has lost her weight drastically from 71kg to 55 kg and now doctor started TB tablets but then also it pains but if she has cyclopam it stops please suggest me something very tense.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
More detailed history please

Detailed Answer:
Hi XXXXXXX
Thanks for your query about your Mother.

To recapitulate: Stomach ache 7 to 8 months- all possible tests - lost weight 71 to 55 - started ATT - pain persists - Responds to cyclopam - needs suggestions...
XXXXXXX please provide me some more information:
- How old is Your Mother?
- How did the pain start? Was there any history of typhoid or so or any bad happening in the family or neighborhood like serious sickness / death or so?
- Please post the reports of all the investigations if possible.
- Has a General Surgeon or a Surgical Gastroenterologist seen her?
- Any Enteroclysis (barium study) under direct visualization done?
- Any history of surgery?
- When was ATT (anti TB) started and any weight gain or improvement in appetite or other symptoms after ATT?
- Any associated symptoms?

Since you have done many tests and must have shown to many Doctors, I would suggest you the following:: (if not already done)
- Enteroclysis (Barium studies)
- Diagnostic Laparoscopy, sometimes helps for a diagnosis and treatment in some instances like cutting of the bands causing subacute obstruction, removal of the appendix if signs of appendicitis.
- Colonoscopy
- A good clinical / physical examination by a Surgeon and / or Gynecologist and you personally can discuss with the Doctors about possibility of Psychological involvement, and treatment if they suspect so. (Chances of Irritable Bowel Syndrome (IBS))

Please give the feedback so that we can discuss further to come to a particular conclusion to help your Mother get diagnosed and cured.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. T Chandrakant (17 hours later)
doctor her age is 50yrs and she had typhoid but not severe
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Can be a complication of Typhoid.

Detailed Answer:
Hi XXXXXXX
Thanks for your feedback.

One of the reasons for pain in abdomen is a complication of typhoid fever.
Typhoid is basically a disease of the last few feet of the small intestine. During Typhoid the lymphoid patches of this part get inflamed and can ooze out the intestinal contents with bacteria into general peritoneal cavity. There can be a small perforation which got healed immediately but caused adhesion in between the intestines.

When did your Mother from Typhoid, recently or in past ?

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. T Chandrakant (27 minutes later)
She had typhoid in XXXXXXX 2013 and yesterday night it was paining her very badly so again she had cyclopam but then also it didn't stop then early morning we gave her syndol then it stop the start of the pain is from back and then entire stomach
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Any other associated symptoms ?

Detailed Answer:
Hi. XXXXXXX 2013 means almost one and half years ago and your Mother has pains for 7 to 8 months.
Then the pain is most likely not related to Typhoid your Mother has.

This time the pain did not respond to Cyclopan; she needed Syndol (Paracetamol 450mg, codeine phosphate 10mg, doxylamine succinate, caffeine 30mg).

The history of ''pain starting from the Back'' and then the entire stomach indicates few things:
-Pancreas
-Stomach
-Spine
-Kidney

The investigations related to these are (if not already done) :
MRCP (Magnetic Resonance Cholangiopancreatography) for Pancreas, liver and gall bladder
MRI of the thoracic Spine to see for any disc or other problems related to spinal cord.
Upper GI Endoscopy for stomach ulcer or so.

Did your mother anytime suffered from Herpes Zoster ?
Was it only the pain or any other symptoms were also present e.g. distension of stomach, nausea, vomiting, visible movement of intestines or Some intestinal noises your Mother perceived (borborygmi), any loose motions or urinary symptoms ?
Where exactly the pain started and did it spread to the whole abdomen or just a particular part of it?

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 18097 Questions

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Suggest treatment for pain in stomach and drastic weight loss

Brief Answer: More detailed history please Detailed Answer: Hi XXXXXXX Thanks for your query about your Mother. To recapitulate: Stomach ache 7 to 8 months- all possible tests - lost weight 71 to 55 - started ATT - pain persists - Responds to cyclopam - needs suggestions... XXXXXXX please provide me some more information: - How old is Your Mother? - How did the pain start? Was there any history of typhoid or so or any bad happening in the family or neighborhood like serious sickness / death or so? - Please post the reports of all the investigations if possible. - Has a General Surgeon or a Surgical Gastroenterologist seen her? - Any Enteroclysis (barium study) under direct visualization done? - Any history of surgery? - When was ATT (anti TB) started and any weight gain or improvement in appetite or other symptoms after ATT? - Any associated symptoms? Since you have done many tests and must have shown to many Doctors, I would suggest you the following:: (if not already done) - Enteroclysis (Barium studies) - Diagnostic Laparoscopy, sometimes helps for a diagnosis and treatment in some instances like cutting of the bands causing subacute obstruction, removal of the appendix if signs of appendicitis. - Colonoscopy - A good clinical / physical examination by a Surgeon and / or Gynecologist and you personally can discuss with the Doctors about possibility of Psychological involvement, and treatment if they suspect so. (Chances of Irritable Bowel Syndrome (IBS)) Please give the feedback so that we can discuss further to come to a particular conclusion to help your Mother get diagnosed and cured.