What are different causes should be considered or rule out while treating patient whose weight reduced in 1-2 years?
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Weight reduction is indicator of Catabolism>Anabolism. this can happened in various NCDs and Infectious diseases.
Thanks for asking this very important question.
Whenever you encounter such patients of weight loss first rule out whether this weight loss is intentionally done or it happened on its own i.e unintentional weight loss.
If the patient has done some changes in his diet or exercise or lifestyle then it is ok, weight loss occurred here is due to these changes.
In case of unintentional weight loss we need to rule out following
1. Uncontrolled DM
3. Any Chronic illness
4. GIT troubles – Hyperacidity, IBS, Constipation etc
Following investigations may help you to arrive on conclusion
CBC : reduced haemoglobin may occur with chronic disease, malabsorption, chronic kidney disease, liver failure.
Raised erythrocyte sedimentation rate (ESR) : nonspecific indicator of disease, malignancy, infection, connective tissue disorder.
Renal function and electrolytes: may indicate chronic kidney disease, Addison’s disease.
Fasting PP blood glucose : diabetes mellitus.
LFTs , clotting screen: liver failure.
TFTs : thyrotoxicosis.
CXR : malignancy, tuberculosis.
Other investigations will depend on the context of the weight loss. Possible further investigations may include HIV serology, endoscopy and autoimmune disease screen
Weight loss that too un-intentional- means without taking any different steps like Dietary changes or Exercises or Medicines or any other pathy medicines should be serious understood and must have following differential diagnosis
1) the side effects of certain medications like phentermine, Lipase inhibitor
-2) alcohol misuse or drug misuse
-3) Chronic kidney, lung or liver disease
-4) a problem with the glands that secrete hormones – such as Addison’s disease or undiagnosed diabetes
-5) a long-term inflammatory condition, such as rheumatoid arthritis or lupus
-6) dental problems – such as losing teeth, having new orthodontics, or mouth ulcers
-7) a condition that causes dysphagia (swallowing problems)
-8) a problem with the gut, such as a stomach ulcer, Crohn’s disease, ulcerative colitis or coeliac disease
-9) a bacterial, viral or parasitic infection, such as persistent gastroenteritis, tuberculosis (TB) or HIV and AIDS,
-10) dementia – people with dementia may be unable to communicate their eating needs