Please help. severe weight loss & rapid exhaustion

[Conor81]

Hello,

I'm seeking assistance on behalf of a friend. He has become very sick recently, and we have had little to no progress with the local hospitals. He is 6ft 3in in height, and was a strong fit man, 30 years of age. In the last 2 months, he has lost 15-20kg and is now fitting into his jeans that he wore when he was 19, his appearance is gaudy and feint and he rapidly loses energy while doing the most trivial of tasks such as getting off a chair, or walking to the end of a corridor.

He explained his symptoms as follows:

If he eats some food, he feels & hears a popping sound beneath his left rib, so this is perhaps the Transverse colon or pancreas, or somewhere in this region. Then within his chest he is overcome with a strange feeling, his heart starts to palpitate rapidly, and he becomes rapidly exhausted. He is suffering headaches a lot now too.. Sometimes these symptoms happen even when he has not eaten.

I'm unsure if he is losing weight indirectly because he is eating less, or if this problem is causing him to lose weight directly.

So, he has been to the hospitals. They have confirmed his blood is clean. An MRI indicated no problems either. They can find no traces of cancer, though he does look like an advanced cancer / leukemia patient due to his loss of colour and weight. Previously the doctors said there was a shadow on his pancreas, but have since said there is no shadow. so, we need to find out more about why they believed there was one initially. He was diagnosed last week with having Barretts disease, but the doctors have said this is incorrect also. The hospital then discharged him, and requested he keep a mobile heart monitor on for the next few days. He did so, and returned it to the hospital. We await their reply.

I hope you can help assist in diagnosing what the problem could be. If we have a few solid suggestions, we can work with this and seek local professionals who deal explicitly with these symptoms.

best regards,

Conor

[Hannahmoo]

Hello...thanks for getting back to me. I hope your friend's holiday proves to be a healing one. I think it's good to get away and allow your body and mind to escape from all the thoughts of sickness. Are you and your friend from outside of the states? I ask this because we generally call it "vacation" ...instead of "holiday" :)

I am in the process of sending all of my medical reports/history to yet another physician. He is at Vanderbilt University. Hoping he can give me direction or diagnosis what is going on.

Keep me posted on your friends progress.
Thanks....

[Conor81]

I hope to find out the info for you soon Hannah, My friend has taken a small holiday away to relax, so i have to wait until he returns

[Hannahmoo]

Hello...Has your friend had a Hida Scan done to test for gallbladder dysfunction or disease. I know it is said that most gallbladder related pain is right sided..however, there are many, many posts of people who had gallbladder disease where the pain was referred to the left side. Many gallbladder patients have also posted rapid heart rates.

You may also want to look into Celiac Disease or Gluten Intolerance. This condition also has similar symptoms. Did you friend have an upper endoscopy?...with biopsies or any blood tests for celiac? Try to look into the symptoms and see if there may be any correlation.

I write this post to you because I too, have similar symptoms...only on my right sidefor three years now and I am still searching for a proper diagnosis. I too have lost 18 pounds on an already thin frame. Very upsetting. My MRI and Ct Scans have come up clear except for "lesions" on the liver which they say are benign hemangiomas! Does your friend feel weakness or ever experience dizziness or lightheadedness? I do...

Hope to hear back from you...and that your friend finds any answer quickly and feels better! Thanks...

[Conor81]

Thank you for your reply, we will look into the tests you have outlined in brackets, and hope to have them conducted.

There was one question I was hoping you would answer in relation to the query above.

"what could cause the "popping" sound beneath his left rib when he eats"?

As this appears to be the first stage that brings forth the rest of the symptoms.

[Poorna Chandra, SMD, DM]

Dear Conor81,

I appreciate your concern for your friend.

Any loss of >10% of body weight in the last 6months or >5% of body weight in 3 months would constitute a significant weight loss. Such a loss if it is involuntary, is usually due to –

1) Immunodeficiency diseases- Primary / Secondary (Immunoglobulin assay, HIV status, CD4 & CD8 counts)

2) Severe malabsorption states (Stool, breath, blood tests and endoscopies biopsies)

3) Disseminated tuberculosis (CT/MRI, endoscopies, Mantoux, Quantiferon)

4) Septic conditions like cholangitis or with an underlying pancreatitis/ chronic meningitis (blood / fluid tests)

5) Severe megaloblastic anemia/ Vitamin B12 deficiencies ( blood test)

6) Disseminated malignancies (CT/MRI, endoscopies)- less likely at this age

7) Mesenteric ischaemia ( CT angio/ Angiography) )- less likely at this age

These would require some dedicated test to look at individual disorders. I would perform the tests mentioned in brackets in any patient with significant weight loss. Cardiac conditions usually lead to a bloated condition and gain in weight.

You should consult your physician to help you prioritize the investigations and help in rehabilitation

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra.