[64F] Experiencing fatigue, gastrointestinal symptoms, and weight loss

Patient Description

A 64-year-old female presents with several months of fatigue, which is worsening and constant, particularly exacerbated by physical activities such as walking and housework, with some relief upon resting. The patient also reports daily gastrointestinal symptoms including nausea, gas, bloating, and burping, without specific food triggers. Notably, there has been a significant weight loss of 15 pounds over 2 ½ months. Stool changes include soft, loosely formed stools, sometimes pencil-thin or diarrhea, alternating with periods of constipation. No bloody stools or severe abdominal pain reported. The patient has a decreased appetite and eats out of necessity. Past medical history includes thyroid issues treated with Synthroid and migraines managed with Pristiq. The patient also takes Align, digestive enzymes, Magnesium, and occasionally Gravol and Tylenol. No known family history of gastrointestinal diseases. No recent use of tobacco or alcohol, and no allergies to medications currently being taken.

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Arora's Assessment

What might be happening

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

  • Gastrointestinal disorders: Given your symptoms of gas, bloating, burping, nausea, and changes in bowel habits, you might have a gastrointestinal disorder. This could include conditions such as irritable bowel syndrome (IBS), gastritis, or peptic ulcer disease. These conditions can cause a variety of symptoms, including those you've described.

    • Treatment typically involves dietary changes, stress management, and sometimes medication.

  • Thyroid disease: You mentioned that you have a history of thyroid issues and are on Synthroid. Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause fatigue and weight changes. It's possible that your thyroid medication needs adjustment.

    • Treatment involves adjusting the dose of your thyroid medication under the supervision of your doctor.

  • Depression: Depression can cause physical symptoms like fatigue, weight loss, and loss of appetite. It can also cause digestive symptoms like those you're experiencing. You mentioned that you're taking Pristiq, which is an antidepressant. If your symptoms are due to depression, it's possible that your medication needs adjustment.

    • Treatment involves adjusting the dose of your antidepressant under the supervision of your doctor, as well as psychotherapy and lifestyle changes.

What you can do

  1. See your doctor: Given your symptoms and their duration, it's important to see your doctor for a full evaluation. They can order tests to help determine the cause of your symptoms and guide treatment.

  2. Monitor your symptoms: Keep a symptom diary, noting when your symptoms occur, what you're doing at the time, and what you've eaten. This can help identify any patterns or triggers.

  3. Stay hydrated and eat a balanced diet: Even if you're not feeling hungry, it's important to eat regular, balanced meals and stay hydrated. This can help maintain your energy levels and prevent further weight loss.

What you should look out for

Seek immediate medical attention if you:

  • Have severe abdominal pain
  • Vomit blood or have blood in your stool
  • Have a fever or chills
  • Experience rapid weight loss
  • Have severe or worsening fatigue

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago

People Also Ask

What could be causing my persistent fatigue and weight loss?

Persistent fatigue and weight loss can be caused by several factors, including thyroid imbalances, gastrointestinal disorders, or depression. It's important to consult with a healthcare provider to determine the underlying cause and appropriate treatment.

How can gastrointestinal disorders like IBS or gastritis be managed?

Management of gastrointestinal disorders such as IBS or gastritis typically involves dietary changes, stress management, and sometimes medication. Keeping a food diary to identify triggers and working with a healthcare provider can help tailor a treatment plan.

Could my thyroid medication be affecting my symptoms?

Yes, your thyroid medication could be affecting your symptoms. Both hypothyroidism and hyperthyroidism can cause fatigue and weight changes. It's important to have your thyroid levels checked regularly and adjust your medication as needed under the guidance of your doctor.

What should I do if I suspect my antidepressant isn't working effectively?

If you suspect your antidepressant isn't working effectively, it's important to discuss this with your doctor. They may consider adjusting the dose, switching medications, or incorporating psychotherapy and lifestyle changes to better manage your symptoms.

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