[41F] Experiencing sudden weight gain and gastrointestinal issues

Patient Description

A 41-year-old female presents with a sudden weight gain of 50lbs over 2 years, primarily in the face and stomach, without changes in diet. Concurrently, she experiences loose stools daily and diarrhea every 3-4 days, described as looking like 'fish flakes'. She reports excessive sweating that soaks through clothes, particularly after showers, and has been ongoing for the same duration. Acid reflux is severe, occurring once a week and sometimes resulting in acid in the mouth, which she has been managing with Prilosec and apple cider vinegar for 20 years. Additionally, she reports fatigue, irritability, anxiety, brain fog, depression, heat intolerance, increased appetite, and has been diagnosed with palpitations. Her medical history includes OCD and ADHD, diagnosed in 2021, and her current medications are Sertraline, Propranolol, and Ritalin. She has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Hyperthyroidism: This condition is caused by an overactive thyroid gland, producing an excessive amount of thyroid hormones. The symptoms can include weight loss, increased appetite, irritability, sweating, heat intolerance, and diarrhea. However, you've reported weight gain, not loss, which is less common in hyperthyroidism.

    • Treatment typically involves medication to slow down the production of thyroid hormones, and in some cases, surgery may be required.
  • Cushing's Syndrome: This condition is caused by high levels of cortisol, a hormone produced by your adrenal glands. Symptoms can include rapid weight gain, particularly of the trunk and face (moon face), depression, anxiety, and irritability. However, diarrhea is not a typical symptom of Cushing's syndrome.

    • Treatment typically involves reducing the amount of cortisol in your body. This could involve surgery, radiation, or medication.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Symptoms include acid reflux and heartburn.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medication or surgery might be needed.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.

    • Treatment typically involves long-term management of diet, lifestyle and stress. More-severe symptoms might benefit from medication and counseling.

Please note that these are possible diagnoses based on the symptoms you've reported. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may refer you to a specialist, such as an endocrinologist or gastroenterologist, for further evaluation.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing at the time, and what foods you've eaten.
  3. Continue taking your prescribed medications as directed by your healthcare provider.
  4. Try to maintain a balanced diet and engage in regular physical activity, which can help manage your weight and overall health.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool
  • Unintentional weight loss
  • Difficulty swallowing
  • Persistent or severe acid reflux

Remember, I'm an AI and this advice is based on the symptoms you've reported. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of Cushing's Syndrome?

Common symptoms of Cushing's Syndrome include rapid weight gain, particularly in the trunk and face, a round face (moon face), high blood pressure, skin changes like bruising and stretch marks, muscle weakness, and mood changes such as depression and anxiety.


How can hyperthyroidism lead to weight gain instead of weight loss?

While hyperthyroidism typically causes weight loss due to an increased metabolism, some patients may experience weight gain due to increased appetite and caloric intake, or due to other factors like muscle loss being masked by fat gain.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD symptoms include avoiding foods and drinks that trigger reflux (such as spicy foods, alcohol, and caffeine), eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and elevating the head of the bed.


What are the treatment options for IBS?

Treatment options for IBS include dietary changes like increasing fiber intake, avoiding trigger foods, stress management techniques, regular exercise, and medications to relieve symptoms such as antispasmodics, laxatives, or anti-diarrheal drugs. In some cases, psychological therapies may also be beneficial.


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