Intestinal distress and weight loss

My mother was diagnosed with ulcerative colitis a year ago at age 73.  She went into remission after a course of prednisone but was encouraged to take a 5-ASA for maintenance.  She tried azulfidine, colazal and asacol and all made her quite ill, primarily with severe abdominal cramping, nausea and diarrhea.
She was taken off all meds and was told that her colon is no longer inflamed.  But she still has bloating, a "heaviness" in her abdomen, cramping, and reduced appetite that comes and goes.  She has lost quite a bit of weight and even though she's trying her best to eat, she can't seem to put any weight back on.  Her doctor says she now has IBS.  She's had a couple of gall bladder attacks also in the past year but the doctor says that this is not the cause of her current symptoms.  Is it possible, as the doctor says, that her whole system is "out of whack" and her intestines just need to calm down?  She doesn't have diarrhea so I don't know if she's malabsorbing.  Should she be tested for malabsorption of fats and/or sugars -- could this be causing her problem?  She never had any GI problems in her life prior to this.  What sort of MD tests for these sorts of things?  Her gastroenterologist, who is a top colitis specialist, hasn't mentioned any of this.

[Kevin Pho, MD]

There are a variety of tests for malabsorption.  The first would be blood tests looking for celiac disease.  Stools can also be sent and analyzed for fat malabsorption.  There are also a variety of tests for carbohydrate malabsorption (i.e. lactose intolerance).  

I would suggest repeating a colonoscopy to evaluate for any inflammation that may cause her symptoms.  You may also want to consider another gastroenterological opinion.  

If IBS is present, there are a variety of treatment options - include antispasmodics, antidepressants, and medications for predominantly constipation or diarrhea dominant IBS.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.