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Losing Weight. Feeling Weak And Bloated. Treated For A Triple A Repair And Kidney Surgery. Any Advice?

Posted on Mon, 25 Feb 2013

Question: My husband has lost about 40 pounds over the last couple of years but has not been trying to do so. He is 6 ft. tall and now weights about 130 pounds. He has a an upper and lower gi in the last 4 years and has also been treated for a triple A repair and kidney surgery. Even with treatment he is still anemic and weight continues to go down. No energy and he sees his MD on a regular basis but she just keeps saying eat more. Some days he does eat very well and other days not so much. Now and again he complains of gut pain and feels bloated. I am at my wits end. What can we do next?

Answered by Dr. Ravi Bansal (7 hours later)

Hello,

Thanks for writing in.

40 pound weight loss is definitely significant and causes of such weight loss include poor intake, any malignancy / tumor, any end organ disease like kidney failure or liver failure and any malabsorption and intestinal diseases.

As I understand his oral food intake is OK... (That is he is eating as much as any person of his age would eat). You can judge that by comparing that with any other family members’ food intake. If this is adequate then we have to look for other reasons.

I could not understand 'He has an upper and lower gi in the last 4 years' - Can you please elaborate? - are you mentioning about endoscopy?

Triple A repair is usually used for abdominal aortic aneurysm surgery - when was it done and what was the cause of that aneurysm is important.

Did he undergo kidney surgery (?nephrectomy) for kidney cancer? If so what was the type of cancer on the biopsy report and whether he is cured of the condition or has any metastatic or residual cancer deposits?

What is his serum creatinine level (blood test marker of kidney function)?

I would like to help you. But kindly provide the above information as much as possible so that I can interpret his condition better.

Waiting for you reply

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ravi Bansal (37 hours later)

Yes, he endoscopy of upper and lower Gi tract. Kidney function has been slightly below normal for the last few years which they blamed on die used for tests. He had cryo surgery for his kidney cancer and it appears the tumor is dying. The kidney drs. felt it was enclosed and that it was not the cause of the weight loss that has happened over the last few years. No one seems to be able to come up with a good ans. for the weight loss plus he is anemic and has been since the triple a repair. He goes back to the GI dr. tomorrow.

Answered by Dr. Ravi Bansal (2 hours later)

Hi and thanks for writing back,

Any tumor or cancer in the body leads to a state of anorexia and catabolism - either the patient does not eat or he is not able to assimilate the nutrients from the diet.

The anemia may be related to aortic aneurysm repair - due to microangiopathic anemia. Stool occult blood is a simple test to identify GI blood loss which may not be visible to the naked eye. Peripheral smear examination, serum iron and TIBC, folate levels and B12 levels should be done to identify cause of anemia.

I think your doctor must already be on to these things. If not, discuss with the doctor. If all are fine, I would suggest you encourage him to eat more, especially the food stuffs which he likes.

You said he has mild kidney dysfunction; but the degree of problem can be judged only by serum creatinine levels. It is important as it will impose certain dietary restrictions.

Hope I answered your query. Let me know if I have missed out any of your concerns.

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Prasad