[50M] Experiencing fatigue, weight loss, and inflammation

Patient Description

A 50-year-old male presents with a 6-month history of fatigue, which has been progressively worsening, particularly in the afternoon. The patient reports unintentional weight loss of 15 pounds over the past two months and a recurrent red rash on the neck and upper chest that flares up when sick, stressed, or after alcohol consumption. The patient experienced a colitis flare-up 6 months ago and subsequent abdominal discomfort. An endoscopy performed 4 months ago showed inflammation and bile in the stomach. Additional symptoms include a metallic taste in the mouth, cold or metallic sensation in the blood, night sweats, joint pain or stiffness in the morning, irritability, and anxiety, particularly in the afternoon and evening. The patient has a history of heavy alcohol use until age 35 but is now abstinent. Current medications include over-the-counter Omeprazole once daily and recreational marijuana use at night for sleep. The patient does not take Benadryl and 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:

  • Autoimmune Disease: Your symptoms of fatigue, weight loss, rash, joint pain, and changes in bowel habits could suggest an autoimmune disease. Conditions such as lupus or rheumatoid arthritis could potentially explain some of your symptoms. These conditions can cause inflammation in various parts of the body, including the skin and joints.

    • Diagnosis typically involves blood tests, and treatment often includes medications to reduce inflammation and manage symptoms.
  • Gastrointestinal Disorders: Your history of colitis, along with current symptoms of abdominal discomfort, changes in bowel habits, and the presence of bile in your stomach, could suggest ongoing gastrointestinal issues. Conditions such as inflammatory bowel disease (IBD) or gastroesophageal reflux disease (GERD) could potentially be involved.

    • Diagnosis typically involves endoscopy or other imaging studies, and treatment often includes dietary changes and medications to manage symptoms and reduce inflammation.
  • Anxiety Disorder: Your symptoms of irritability and anxiety could potentially suggest an anxiety disorder. Anxiety disorders can cause physical symptoms, and stress can exacerbate many of the symptoms you're experiencing.

    • Diagnosis typically involves a psychological evaluation, and treatment often includes psychotherapy, medications, or both.

Please remember that this is not an exhaustive list of possible conditions, and these conditions may not fully explain all of your symptoms. It's also possible that more than one condition could be contributing to your symptoms.

What you can do

  1. Schedule an appointment with your primary care doctor to discuss your symptoms. They can provide a formal assessment and order relevant tests if necessary.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing when they occur, and anything that seems to make them better or worse. This can help your doctor identify patterns and potential triggers.
  3. Try to maintain a balanced diet and regular exercise routine, as these can help manage symptoms and improve overall health.
  4. Consider seeking support from a mental health professional to help manage your feelings of irritability and anxiety.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Blood in your stool
  • A rash that is spreading rapidly or causing severe discomfort
  • Severe joint pain or swelling
  • Symptoms of a severe allergic reaction, such as difficulty breathing or swelling of the face, lips, tongue, or throat

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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9 mo ago


People Also Ask


What are common symptoms of autoimmune diseases like lupus or rheumatoid arthritis?

Common symptoms of autoimmune diseases such as lupus or rheumatoid arthritis include fatigue, joint pain, skin rashes, fever, and weight loss. These conditions can cause inflammation in various parts of the body, leading to a range of symptoms.


How can gastrointestinal disorders like IBD or GERD be managed effectively?

Management of gastrointestinal disorders like IBD or GERD often involves dietary changes, medications to reduce inflammation and acid production, and sometimes lifestyle modifications such as stress management and avoiding trigger foods.


What are some strategies to cope with anxiety and irritability?

Strategies to cope with anxiety and irritability include practicing relaxation techniques like deep breathing or meditation, engaging in regular physical activity, seeking support from a mental health professional, and possibly using medications as prescribed by a healthcare provider.


What lifestyle changes can help alleviate fatigue and improve overall health?

Lifestyle changes that can help alleviate fatigue and improve overall health include maintaining a balanced diet, getting regular exercise, ensuring adequate sleep, managing stress effectively, and avoiding substances like alcohol and recreational drugs.

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