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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Significant Weight Loss, Nauseated, Fatigued, Dark Stools, Lower Abdomen Discomfort. Reason ?

My mother has had significant weight loss, (about 5-10%) in 3 months, is nauseated, especially in the morning, and is fatigued. She is 71 years old and has never been sick and has never had depression. She is a non-smoker and a non-drinker. She has a hgb of 162. currently her c-reactive protein is normal. She describes her stools to be dark but not black. She also has a uti, which is being treated. She had an abd ultrasound 2 years ago because of symptoms of lower abd discomfort but they saw nothing. She is to have a colonoscopy and and gastroscopy as well as another ultra sound and possibly a CT of the abd.
Tue, 18 Jun 2013
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General & Family Physician 's  Response
Hello,
As per your statement your mother is C/O
1) Nausea in the morning
2) Loss of weight
3) Fatique
4) Dark colored motion
All investigations done - Hgb and C-reactive proteins are normal - So we can't expect any major inflammatory disease.
USG abdomen done 2 years back was normal
She is waiting for gastroscopy and colonoscopy and repeat USG abdomen and possibly a CT abdomen.
First you must arrive at a probable diagnosis and then investigation should be as per the probability.
You have not mentioned whether she is having DM/HT/IHD.
Even a UTI can produce all the symptoms you have mentioned
Probable Diagnosis.
Do a urine analysis - Macro, Micro and culture and sensitivity
Do a motion examination - Macro, Micro, RBC and culture and sensitivity.
If RBC is present - it may be GI Bleed
From the above you can come to a conclusion - what investigation is needed further.
Accordingly you do the investigation and treat her - instead of subjecting her to the cumbersome unwanted investigation.
She will get alright - because I don't expect any major problem.
Best wishes



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Significant Weight Loss, Nauseated, Fatigued, Dark Stools, Lower Abdomen Discomfort. Reason ?

Hello, As per your statement your mother is C/O 1) Nausea in the morning 2) Loss of weight 3) Fatique 4) Dark colored motion All investigations done - Hgb and C-reactive proteins are normal - So we can t expect any major inflammatory disease. USG abdomen done 2 years back was normal She is waiting for gastroscopy and colonoscopy and repeat USG abdomen and possibly a CT abdomen. First you must arrive at a probable diagnosis and then investigation should be as per the probability. You have not mentioned whether she is having DM/HT/IHD. Even a UTI can produce all the symptoms you have mentioned Probable Diagnosis. Do a urine analysis - Macro, Micro and culture and sensitivity Do a motion examination - Macro, Micro, RBC and culture and sensitivity. If RBC is present - it may be GI Bleed From the above you can come to a conclusion - what investigation is needed further. Accordingly you do the investigation and treat her - instead of subjecting her to the cumbersome unwanted investigation. She will get alright - because I don t expect any major problem. Best wishes