Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Is There Really Such Thing As A Nervous Stomach?

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Digestive


I am a 34 year old female who, in early July, abruptly began having loss of appetite, queasiness, diarrhea, mucous in stools, etc. These bouts were intermittent. Finally after a month, my GI doc suspected giardia and I was treated. I got about a 75% improvement. I had 2 episodes of mild diarrhea after treatment. What I have been left with is upper GI problems--early satiety, queasiness after eating saucy, spicy, or fried foods. During all of this I experiened a 10lb weight loss. I managed to maintain my weight since early August until now. This past Friday I had to visit my regular doctor for a check up (he was aware of my GI problems). He was somewhat concerned about my weight loss. He is running another CBC, and a CHEM24 panel to check my blood sugar, and kidney/liver function. Well, I got really upset. Since my appt on Friday, I have lost 2 more lbs, can't eat, and am full of anxiety. My doctor also thinks I have a mild form of reflux (I have no heartburn though). He told me to take Pepcid AC for a week to see if it helps and to let him know if it does or doesn't.

My question is--could all of the anxiety I have experienced since early July (due to my diarrhea/nausea) made my stomach worse? Can anxiety and worry really cause this continued weight loss and affect my appetite? I do have a problem with anxiety when I get sick (I'm a hypochondriac). I am sure that I have some form of cancer causing my weight loss. When all of this started I weighed about 149. I am now at 136. I'm 5'7". I have been trying to keep track of what I eat. On "bad days" I get in about 1200 calories. On a good day I eat about 1900. Are these calories too low to maintain a normal weight? I think I used to eat about 3000 calories per day!!! How many calories do I need to eat to maintain weight? By the way, my giardia tests were negative and I had a flexible sigmoidoscopy that was normal. In July I had a normal CBC and a normal sed rate test. My thyroid function tests are normal.

Christine

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Dear christine,
Yes, there is a condition of nervous stomach that most people experience when anxious. Before attributing your symptoms to anxiety ( and in essence stopping the search for treable causes of your symptoms), it is necessary to exclude several problems that could cause your symptoms. It is essential to exclude Giardia infection. Gastroparesis can cause the symptoms that you desribe. A gastric emptying study will determine if impaired emptying is your problem. Thyroid disease must also be excluded. One must also exclude intestinal mucosal disease that might cause malabsorption. It is unlikely that you have cancer, but if your symptoms persist you may need tests to exclude the more common tumors.

Your caloric needs are a function of your size and activity. Eating 1200 calories may lead to slow weight loss if you are moderately active. 1900 calories per day should maintain your weight or even cause some weight gain

HFHSM.D.-rf
8keywords: weight loss, giardiasis
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