rapid weight loss - please help

[sudesh]

Hi,
   My name is sudesh. All was well until about 4 weeks ago in
India, when I had a sudden bout of abdominal pain & diarrhea
(15 times a day)(Prior to this episode , I had outside food from a nearby cafiteria for 1 week) . I was hospitalized and given IV Levo-flox +
Tinidazole. Next day the Diarrhea was arrested and was sent home
with Levo-flox (500mg/day) + tinidazole tabs (1.5gms / day).
My stools were still very soft with tiredness, irritation in my bowels. 4 weeks from then , I still don't have a good appetite
(though I eat enough) and have lost 14 lbs was 214lbs and now am 200lbs (my age: 35, height: 5'9").
Over there tests have been done :
Sed rate : 10
Creatinine : 0.9
WBC : 5500 CBC normal. HB 14gms, RBC: 5.7, Differential - normal
etc.
Stool test : negative (occult blood -ve) no ova, cyst, vegetative forms)
Urine test : -ve

Since my weight didn't stabalize, My Gastro did a EGD (upto
jejunum) with biopsies and a colonoscopy (into terminal ileum).
I have also done a CAT Scan with IV contrast + Barium oral
contrast (-ve) . My LFT (Liver function tests) are normal.
Metabolic profile - Normal. CBC w/ differential - Normal.

4 months ago ---
tests were done because of my liver lesion stable over 8 months
was found to be 8mm liver cyst. Barium Meal w/ scout study -- normal, ANA, AMA, Mitochondrial Abs : -ve. Ultrasound of abdomen -ve (several MRI of abdomen etc done , all showing a
simple hepatic cyst, stable over time).

I STILL AM VERY TIRED AND AM LOOSING WEIGHT . WHAT IS GOING ON ?

regards,
sudesh

[Kevin Pho, MD]

Hello - thanks for asking your question.

You have already been evaluated by physicians - please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only.

You describe weight loss after a bout of diarrhea 4 weeks ago.  You have been treated with antibiotics.  Endoscopy, stool culture, O&P, CT scan, and all blood work has been normal.

You continue to have involuntary weight loss with a poor appetite.  There are many potential causes for this that you may want to discuss with your personal physician.

Endocrinopathies — Several endocrinopathies may lead to weight loss with decreased appetite:

Adrenal insufficiency — Virtually all patients with chronic glucocorticoid deficiency have anorexia, nausea and weight loss.

Hypercalcemia — Hypercalcemia causes anorexia (and nausea) and weight loss.

Chronic illness — Any chronic systemic or infectious illness, affecting any system, can cause anorexia and weight loss.

Gastrointestinal diseases — Loss of appetite and therefore decreased food intake and weight loss occur in patients with most gastrointestinal diseases::

- Dysphagia
- Sensation of satiety
- Vomiting and regurgitation
- Abdominal pain or discomfort
- Chronic inflammation and cancer
- Malabsorption
- Spontaneous and surgical fistulas and bypasses

The fact that you were recently hospitalized may contribute to your weight loss.  You may want to discuss tests to evaluate for malabsorption or any endocrine abnormalities (i.e. thyroid test, testing for adrenal insufficiency) 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.

Thanks,
Kevin, M.D.

[sudesh]

I forgot to add that the following tests were also done :
6 months ago : EBT High res scan of Lungs & chest (-ve)
5 days ago : Chest X-ray (-ve)