[52F] With unexplained weight loss, itching, and gastrointestinal symptoms post-cholecystectomy

Patient Description

A 52-year-old female presents with a 44-pound unexplained weight loss, tingling itching on the soles of her feet and palms for the past week, bloody bile diarrhea for the past 9 months, and hot flashes following gallbladder removal. The itching is somewhat relieved by Benadryl. The diarrhea occurs 2-3 times daily and is accompanied by middle abdominal cramping. There are no known triggers or patterns for the symptoms, and no recent changes in diet, medications, or environment. The patient denies any previous medical conditions or surgeries other than the gallbladder removal and has no family history of liver disease or gastrointestinal issues. No alcohol or recreational drug use reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Unexplained Weight Loss and Bloody Diarrhea:

    • Gastrointestinal Issues: Conditions like inflammatory bowel disease (IBD), including Crohn's disease or ulcerative colitis, can cause bloody diarrhea and significant weight loss. These conditions often require a combination of medication and lifestyle changes for management.
    • Infections: Certain infections, such as those caused by bacteria like Clostridium difficile, can lead to bloody diarrhea and weight loss. These typically require antibiotic treatment.
  2. Itching Soles of Feet and Palms:

    • Liver Dysfunction: Itching, especially on the palms and soles, can be a sign of liver issues, such as cholestasis, where bile flow is reduced or blocked. This can occur post-gallbladder removal and may require further evaluation and treatment by a healthcare provider.
    • Allergic Reactions: Although you haven't started any new medications or products, it's still possible that an allergic reaction could be causing the itching.
  3. Hot Flashes Post-Gallbladder Removal:

    • Hormonal Changes: Hot flashes can be related to hormonal changes, which might not be directly related to gallbladder removal but could coincide with other changes in your body.
    • Post-Cholecystectomy Syndrome: Some people experience a range of symptoms after gallbladder removal, including digestive issues and hot flashes. This condition can be managed with dietary changes and medications.

What you can do

Itching Soles of Feet and Palms:

  • See a Doctor: Given the sudden onset and the possibility of liver dysfunction, it's important to consult a healthcare provider. They may recommend blood tests to check liver function.
  • Topical Treatments: Over-the-counter antihistamines like Benadryl can help with itching. You can also try moisturizing lotions or creams to soothe the skin.

Unexplained Weight Loss and Bloody Diarrhea:

  • Seek Immediate Medical Attention: Bloody diarrhea and significant weight loss are concerning symptoms that require prompt evaluation. Your doctor may recommend stool tests, blood tests, and possibly imaging studies or a colonoscopy to determine the cause.
  • Stay Hydrated: Ensure you are drinking plenty of fluids to stay hydrated, especially with ongoing diarrhea.

Hot Flashes:

  • Monitor Symptoms: Keep track of when the hot flashes occur and any potential triggers. This information can be helpful for your healthcare provider.
  • Lifestyle Adjustments: Wear light clothing, stay in cool environments, and consider using fans or air conditioning to manage hot flashes.

What you should look out for

Given the severity and combination of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe Abdominal Pain: If the cramping becomes severe or unbearable.
  • Signs of Severe Dehydration: Such as dizziness, dry mouth, or reduced urine output.
  • Persistent or Worsening Symptoms: If your symptoms continue to worsen or do not improve with initial treatments.

Remember, while I can provide some guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago

People Also Ask


What could cause unexplained weight loss and bloody diarrhea?

Unexplained weight loss and bloody diarrhea can be caused by gastrointestinal issues such as inflammatory bowel disease (IBD) or infections like Clostridium difficile. These conditions require medical evaluation and treatment.


Why might someone experience itching on the soles of their feet and palms?

Itching on the soles of the feet and palms can be a sign of liver dysfunction, such as cholestasis, or an allergic reaction. It's important to consult a healthcare provider for proper diagnosis and treatment.


Are hot flashes common after gallbladder removal?

Hot flashes are not directly related to gallbladder removal but can occur due to hormonal changes or as part of post-cholecystectomy syndrome. Monitoring symptoms and lifestyle adjustments can help manage them.


What should I do if I experience severe abdominal cramping and diarrhea?

If you experience severe abdominal cramping and diarrhea, it's important to seek immediate medical attention. These symptoms could indicate a serious condition that requires prompt evaluation and treatment.


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