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Gastroenterology  (Expert Forum)
 | 
LOWER ABDOMAN DISCOMFORT -LOSING WEIGHT
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

LOWER ABDOMAN DISCOMFORT -LOSING WEIGHT

by barrie12, Nov 06, 2006 12:00AM
Three months ago I went for my physical and the doc noted that I was three pounds lighter than the previous year.  I have always been careful about what I eat and still found it hard to lose weight Since then I have lost another 4 pounds. Appetite is fine , in fact I have been consuming more calories than usual. Im not a big person and I used to gain weight easily.

One month ago I had complete blood work done by an endocrinologist and everything was normal.  I did have a unrinary infection and that was treated by a urologist and cleared up.

Within the last month I have been having excessive gas and unpleasant pressure in my lower abdomom.  Sometimes it spreadsaround to my sides. I feel it even during the night My bowel movements are normal but I feel like I need to go when I don't.  THe only thing unusual is that every so often they are  light in color.

I was seen my my gynecologist and he did a transvaginal ultrasound and saidys my symptoms are not gynecological

I  had a CAT Scan and Ultrasound of the abdoman, normal. My internist then told me no further testing needs to be done but I told him I am still not feeling well and he to me to see a gastro. doc.

I saw the gastroenterologist last week, she reviewed my tests and told me the same thing. This same doc had given me a colonocopy exaactly a year ago and there was one tiny polup.
She told me to eat fiber and come back in three weeks. I told her that I am becoming very concerned about the almost constant stomach discomfort and weight loss.  She said that weight loss can come from many things and that its hard to pin down. I also have a constant dry mouth but she said that is totally unrelated.

I would appreciate any help.

by Kevin Pho, MD, Nov 07, 2006 12:00AM
You have had a pretty comprehensive evaluation, including a CT scan and colonoscopy.  This would rule out many of the major disorders - such as colitis or inflammatory bowel disease.  

More specialized testing can be considered - including sending the stool off for malabsorption or blood tests looking for celiac disease.  

If the tests continue to be negative, treatment for irritable bowel syndrome can be considered with tricyclic antidepressants, antispasmodic agents, or antibiotics like Rifaximin.

If the discomfort is upper GI in origin, an upper endoscopy can be considered.

These options can be discussed with your personal physician.

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.

Kevin, M.D.
kevinmd_
Member Comments (3)

by hbp702, Nov 06, 2006 12:00AM
To: barrie12
Unexpected weight loss and dry mouth (loss of water?) - check for diabetes.

Diabetes is due to the pancreas malfunctioning - it can also be malfunctioning in the exocrine (digestive) sense, not just the endocrine (diabetes, other hormones) sense.

by hbp702, Nov 06, 2006 12:00AM
To: barrie12
I forgot to add - since you had a "complete" blood work by an endo - have him run a GTT.

If you pass the fasting glucose, they won't run a GTT or a A1C unless you ask.

You can have diabetes with an FPG under 126 (or even "normal) if the 2HR post-prandial is over 200. That would still be diabetes, would still cause you to lose water and sugar (calories, and hence weight) due to renal losses when the glucose spikes high, still can cause damage to the body, and still indicates pancreas problems.

I hope not, but if it were me, I'd ask for the GTT.

I had a normal FPG and was diagnosed with IGT based on a GTT. The GTT is more sensitive.

by barrie12, Nov 06, 2006 12:00AM
To: hbp702
Thanks,

Were you any more hungry than usual?  Im eating more just because I would like to gain weight (its not working) but Im not really hungrier and I thought that was also a symptom of diabetes
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