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What is wrong with me? (Loss of appetite/weight, bloating, gassiness)

Hello, I am writing on this forum out of desperation. I am a 22 year old female who is 5’8 tall and 120-130 pounds (basically I am thin) and has had no major gastroenterological problems in my medical history. I do not drink alcohol at all, besides very limited and very few social events. I have had gastroenterological problems since July 2020, and I have been seeking doctors since September 2020.

First, I have been seeing my primary care physician, and now, I am scheduled to see a gastroenterologist in about a month. So yes, while I am seeking the Internet for medical advice, I am speaking to doctors as well. I have been experiencing a loss of appetite, which has contributed to a loss of weight of 5-8 pounds. When I eat "too much" food I feel an uncomfortable stomach pain and gassiness, and I often have to lie down for it to go away. And by "too much", I mean that my stomach can take significantly less food than it used to. There are times when I don't feel appetite at all, which is abnormal for me. The gassiness and bloating happen only when I am full. I notice there are foods that really trigger this discomfort: fatty meats (beef, veal, etc), for example. Also, I have had a huge alcohol intolerance for more than a year (smallest sip of alcohol makes me nauseous/vomit). This has caused my PCP to consider problems with my gallbladder and liver.

I do not have diarrhea or constipation.

I have taken a month of omeprazole, which has had no effect at all. I then had a full abdominal scan at a nearby hospital, where all things were listed as "unremarkable" (no gallstones were seen). My PCP has noticed, after pressing down on my abdomen, that one part of it was most uncomfortable: my epigastric region. Now, my PCP is consulting a gastroenterologist and I will be seeing them early February. This has been difficult to deal with, and I cannot help but think that I have the worst possible conditions. No Google search has given me a lot of clarity, and I am simply hoping that maybe I can find a little clarity on this forum. Thank you so much!

________________________________________

My partner has helped me write a rough SOAP note format to clear things up, here is what I am describing:

Subjective: a 22 yo female, is complaining of lack/change in appetite for 6 months. This has resulted in a weight loss of 5-8 lbs over this period of time. She also complains of associated epigastric discomfort, also for 6 months, a gassy/bloating pain, 3/10 pain severity. Frequency: every day. Duration: constant. Gassiness, like belching after eating, is increased during and after times of eating. Makes it better: belching. Makes it worse: ingestion of food (especially fatty foods) and alcohol consumption.

Allergies: NKA

Medications: Birth control (Lutera) taken once a day.

Medical Hx: motion sickness, no past hospital admission

FH: mom had hyperthyroidism, grandpa died of colon cancer

SH: no EtOH, no tobacco, no illicit drugs, no caffeine.

Sexual Hx: G: 0; P: 0; A: 0. Menstruation: 4-5 days



Objective:

General appearance: well developed, young adult female, AOx3.

Vital signs: all within normal limits

Gastro: No abd tenderness, rebound or otherwise in any region upon palpation. Normal bowel sounds. No masses, solid or mobile.

Assessment:

(no DDxs yet)

Plan:

-        Follow up with gastroenterologist on Feb. 2nd
-        Gastric Ultrasound: did not show any gastric masses or irregularities
2 Responses
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Avatar universal
This is a common symptom with numerous possible causes. This article may be of benefit:

https://www.uptodate.com/contents/approach-to-the-adult-with-dyspepsia

Hopefully this will help prepare you for your upcoming gastroenterologist appointment.
Helpful - 0
Avatar universal
Any relevant labs?
Helpful - 0
2 Comments
I realize now that what I have been facing is called "indigestion".

In August 2020, I had bloodwork done, which nothing was seen as out of the ordinary. I would send you the report if there was a way to.
In October 2020, I was tested for H. Pylori using a stool sample, and it came back negative.
In December 2020, I had an abdomen ultrasound which came back as "unremarkable", here are the results:
Impression
Unremarkable abdominal ultrasound.

Narrative
US ABDOMEN COMPLETE

CC/DX: R10.13: Epigastric pain
R14.0: Abdominal distension (gaseous)
K90.49: Malabsorption due to intolerance, not elsewhere classified.

Comparison: No existing relevant studies available for correlation.

Technique: Representative real time permanent images of the abdomen are
obtained.

Discussion:

Gallbladder: No gallstones seen. No gallbladder wall thickening. No
pericholecystic fluid.

Biliary ductal system: No intra or extra hepatic ductal dilatation. Common bile
duct measures about 2.6 mm, within normal limits.

Liver: 13.5 cm in length. Unremarkable.

Pancreas: Unremarkable.

Spleen: 10.5 x 3.5 x 10.2 cm. The volume is 195.5 cc (normal range - 107.2 to
314.5 cc with average of about 214.6 cc).

No ascites.

Right kidney: 10.6 x 3.5 x 4.6 cm. No mass, hydronephrosis or calcification.
Vascular flow is noted.

Left kidney: 10.9 x 5.3 x 4.6 cm. No mass, hydronephrosis or calcification.
Vascular flow is noted.

Aorta: Unremarkable.

IVC: Unremarkable.

I am seeing my gastroenterologist on February 2. I wish I had a name for what has been causing the symptoms I have been experiencing: indigestion, lack of appetite, and gassiness - but no doctor has been able to give one yet.
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