Brief Answer:
Dietitian necessary.

Detailed Answer:
Hi XXXXXXX
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Looking at the query, my opinion is as follows:

1. Weight loss could be due to tissue loss or fluid loss.

2. Your calorie or fluid intake is important to assess any causes. If you are on a specific carbohydrate diet, protein/muscle loss could be causing you to loose weight. You will require atleast 1g/kg/day of protein every day to maintain normal growth/metabolism.

3. To avoid any future risk of appendicitis, which can get complicated at this age, your surgeon removed the appendix. This is a vestigial organ and serves no function. Not to worry.

If they have removed, some amount of intestine, reduced area of nutrition absorption would be present. If this is the case, you will need to take more nutrition/food to get the same amount of nutrients into your system compared to your previous life style before surgery. You need to take more food to avoid loosing weight.

4. I require more details to comment about your weight loss.

a. Daily calorie intake - All from carbohydrates, fat and proteins. If you are not sure - give an example of your daily usual diet.

b. Daily protein and fluid intake

c. Exercises

d. How much amount of intestine removed during surgery?

As you are no suffering from any other diseases and all diseases are in remission or not causing any complication, I will require more details to comment further. If you are able to give me more details, I can help you further.

If you have no specific complication, other than weight loss - best person to meet would be a dietitian to chart your diet to make sure you are getting adequate nutrition.

Hope it helps.

Any further queries, happy to help again.

Dr. Prakash HM

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Brief Answer:
Reduced absorption

Detailed Answer:
Hi XXXXXXX

Thanks for replying.

You are following the SCD diet very well and its helping you well.

I looked at your diet. Your diet is nutritious and very well designed to rest the gut and also maintain weight. If you need to gain weight, quantity needs to be increased. As you have stopped processed food almost completely, fat stores formation will take longer.

However, I would not advise you to come out of your diet. You are having the good time with it and continue with it. Try to take multiple meals 6-8 atleast.

Passing stools 3 times a day is high normally. It indicates faster gastro-intestinal motility. Absorption of food takes time and due to increased gastro-intestinal motility, food getting absorbed is very less and hence, your weight gain is not happening.

Earlier, it was more diarrhea, mucus etc, due to colonic disorder. Now, even though it is well formed, absorption amount is limited. Try to increase quantity.

Also, due to age related mucosal changes in gastro intestinal tract, absorption will also be less.

Reduced absorption due 1. mucosal changes and 2. increased gastro-intestinal motility is causing decreased amount of nutrition reaching the system and hence, weight gain is not happening.

Increasing the quantity will help possibly. You can also consult a dietitian.

First, try to increase quantity of the present schedule, multiple meals (more food around the gut, possibly more absorption). Try it for a month or two. If no further changes, you can consult a dietitian to help you gain weight.

Also additionally,
1. Sleep regularly and atleast for 8-9 hours in night.
2. Moderate exercises with avoidance of stress is necessary.

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM

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