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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Sudden Weight Loss With Nausea And Vomiting?

Husband is losing weight fast and body temperature drops an cant eat due to a hurting in is right side side hurts as soon as he eats and gets nausea and soon vomits Has no gallbladder, no appendix. He has had a number of bowel obstructions in the past but CT scan says he is fine Has been in the hospital 2 X in May and still no answers.
Mon, 5 Dec 2016
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Dietitian & Nutritionist 's  Response
Hello dear. It is very difficult to assess such a problem with limited information but I realize how frustrated you are so let me give you some ideas based on the information that you have provided.

Losing weight quickly, pain in right side, frequent bowel obstructions, frequent nausea and recurrent vomiting are indicative of a condition called gastroparesis, or a slowing down of the movement of food through the intestines. Absence of gallbladder also causing problems with digestion.
To prevent further bowel obstructions and decrease pain and alleviate some of the symptoms you can follow one of two tracks. Have husband tested for gastroparesis or go ahead and try the diet for gastroparesis which is soft, low fiber foods eaten in small meals 4-6 times daily. Do not lie down after eating for a few hours and do not eat before bedtime. If you see some results then you know you are headed in the right direction. Some of my clients have to stick to liquids and liquid medications their gastroparesis is so severe. Medication wise it can be treated by such drugs as erythromycin, reglan and others, but usually only after the doctor performs a gastrointestingal scintography test to determine how fast your gut processes food. Also, do not overfill stomach, again small, frequent LOW FAT
meals.

You may also try introducing some digestive enzymes. Lipase will help digest what fat is in the diet and is missing from gallbladder secretions. There are over the counter digestive aides or you can ask your doctor about such supplementation and its possible benefits. Generally the digestive aides will come with lipase, amylase (starch) and protease (proteins). If fat is not being digested properly you may see floaty stools and this is another indication of malabsorption.

If malabsorption is present of fat, the fat soluble vitamins A,D,E and K may be affected. This is another reason for taking digestive enzymes and possibly water soluble supplements of the fat soluble vitamins mentioned above. Have doctor check vitamin D level to give indication of absorption.

Information that would have been helpful is the following: did symptoms start after gallbladder removed and when was it removed? You are to follow a strict low fat diet for several months after removal.

Next, how long has the obstructions been occurring and were they happening before gallbladder stones and/or surgery? Have you noticed certain foods produce more symptoms than others? Was constipation a problem as a child? Are there any known food allergies or intolerances? What is current diet and bowel habits? What are medications and or supplements being taken right now?Was CT done with a radioactive isotope? Need to have scintography to determine medical diagnosis of gastroparesis but do not know if it was done. Is there any gas rectally or in the form of burping? Intestinal gas slows motility and also needs to be addressed in the form of a food intolerance or altered motility.

I hope I have given you some insight into what to discuss with your doctor at the next visit and some foods/ supplements you can try to alleviate the symptoms.

I can visit with you more extensively after more information is obtained from previous studies done or information asked for above.

Best Wishes, Kathryn Shattler, MS,RDN
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What Causes Sudden Weight Loss With Nausea And Vomiting?

Hello dear. It is very difficult to assess such a problem with limited information but I realize how frustrated you are so let me give you some ideas based on the information that you have provided. Losing weight quickly, pain in right side, frequent bowel obstructions, frequent nausea and recurrent vomiting are indicative of a condition called gastroparesis, or a slowing down of the movement of food through the intestines. Absence of gallbladder also causing problems with digestion. To prevent further bowel obstructions and decrease pain and alleviate some of the symptoms you can follow one of two tracks. Have husband tested for gastroparesis or go ahead and try the diet for gastroparesis which is soft, low fiber foods eaten in small meals 4-6 times daily. Do not lie down after eating for a few hours and do not eat before bedtime. If you see some results then you know you are headed in the right direction. Some of my clients have to stick to liquids and liquid medications their gastroparesis is so severe. Medication wise it can be treated by such drugs as erythromycin, reglan and others, but usually only after the doctor performs a gastrointestingal scintography test to determine how fast your gut processes food. Also, do not overfill stomach, again small, frequent LOW FAT meals. You may also try introducing some digestive enzymes. Lipase will help digest what fat is in the diet and is missing from gallbladder secretions. There are over the counter digestive aides or you can ask your doctor about such supplementation and its possible benefits. Generally the digestive aides will come with lipase, amylase (starch) and protease (proteins). If fat is not being digested properly you may see floaty stools and this is another indication of malabsorption. If malabsorption is present of fat, the fat soluble vitamins A,D,E and K may be affected. This is another reason for taking digestive enzymes and possibly water soluble supplements of the fat soluble vitamins mentioned above. Have doctor check vitamin D level to give indication of absorption. Information that would have been helpful is the following: did symptoms start after gallbladder removed and when was it removed? You are to follow a strict low fat diet for several months after removal. Next, how long has the obstructions been occurring and were they happening before gallbladder stones and/or surgery? Have you noticed certain foods produce more symptoms than others? Was constipation a problem as a child? Are there any known food allergies or intolerances? What is current diet and bowel habits? What are medications and or supplements being taken right now?Was CT done with a radioactive isotope? Need to have scintography to determine medical diagnosis of gastroparesis but do not know if it was done. Is there any gas rectally or in the form of burping? Intestinal gas slows motility and also needs to be addressed in the form of a food intolerance or altered motility. I hope I have given you some insight into what to discuss with your doctor at the next visit and some foods/ supplements you can try to alleviate the symptoms. I can visit with you more extensively after more information is obtained from previous studies done or information asked for above. Best Wishes, Kathryn Shattler, MS,RDN