Gastrointestinal Tract

Appetite is the desire to eat. A decreased appetite is when you have a reduced desire to eat. This occurs despite the body's basic caloric (energy) needs.

Loss of appetite; Decreased appetite

Any illness can affect a previously hearty appetite. If the illness is treatable, the appetite should return when the condition is cured.

Loss of appetite can cause unintentional weight loss.

Depression in the elderly is a common cause of weight loss that is not explained by other factors.

• Anorexia nervosa
• Cancer
• Chronic liver disease
• Chronic kidney failure
• Emotional upset, nervousness, loneliness, boredom, tension, anxiety, loss, and depression
• HIV
• Hypothyroidism
• Infections
• Medications and street drugs
  • Amphetamines
  • Antibiotics
  • Chemotherapy drugs
  • Codeine
  • Cough and cold medications
  • Digitalis
  • Demerol
  • Morphine
  • Sympathomimetics, including ephedrine
• Pregnancy (first trimester)

Increase proteinand calorie intake by eating high-calorie, nutritious snacks or several small meals during the day. Liquid protein drinks may be helpful.

Family members should try to supply favorite foods to help stimulate the person's appetite.

Keep a record of what you eat and drink for 24 hours. This is called a diet history.

If a person with anorexia nervosa consistently exaggerates food intake, someone else should keep strict calorie and nutrient counts.

For loss of appetite caused by taking medications, ask your health care provider about changing the dosage or drug. Never stop taking medications without first talking to your health care provider.

See also: Weight management

Call your health care provider if you are losing a lot of weight without trying.

Your doctor will perform a physical exam and will check your height and weight. Your diet and medical history will be reviewed. The doctor wll ask questions about your decreased appetite, including:

• Quality
  • Is the decreased appetite severe or mild?
  • How much weight have you lost?
• Time pattern
  • Is loss of appetite a new symptom?
  • If so, did it start after an upsetting event, such as the death of a family member?
• What other symptoms are present?

Tests that may be done to determine the cause of a decreased appetite may include:

• Abdominal ultrasound
• Barium enema, sigmoidoscopy, or colonoscopy (if colon cancer is suspected)
• Complete blood count (CBC)
• Erythrocyte sedimentation rate
• HIV test
• Kidney function tests
• Liver function tests
• Pregnancy test
• Thyroid function tests
• Upper GI series
• Urine drug screening

In cases of severe malnutrition, nutrients are given through a vein (intravenously). This may require a hospital stay.

A percutaneous transhepatic cholangiogram (PTCA) is an x-ray of the bile ducts inside and outside the liver. The x-ray is taken after contrast medium (dye) is injected directly into the bile ducts.

PTCA; Cholangiogram - PTCA

The test is performed in a radiology department by a radiologist. You will be asked to lie on your back on the x-ray table. The upper right side of your abdomen will be cleansed and you will be given a local anesthetic. A long, thin, flexible needle is then inserted through the skin into the liver.

With guidance from an x-ray machine that projects images onto a TV screen (fluoroscope), the bile duct is located and the contrast medium injected. The contrast medium then flows through the ducts and can be seen on the fluoroscopic monitor.

Inform the health care provider if you are pregnant. You will be given a hospital gown to wear and will be asked to remove all jewelry.

There will be a sting as the anesthetic is given and some discomfort as the needle is advanced into the liver. You may be given medication for sedation and/or pain control. Generally, the x-ray itself causes little or no discomfort.

Bile is a by-product of protein metabolism. It is created in the liver and removed from the body through the intestines via the bile ducts. It contains bilirubin, which is a product of normal metabolism. If bile cannot be removed from the body, bilirubin collects in the blood and is seen as a yellow discoloration of the skin and eyes (jaundice). One cause of this is a blockage of the bile ducts.

Also, the pancreas creates digestive fluids, which drain via a common bile duct into the intestine. A blockage can prevent the fluids from draining, and may cause pancreatitis (inflammation of the pancreas).

A PTCA test can help identify whether a blockage is causing the jaundice or pancreatitis.

The bile ducts are normal in size and appearance for the age of the patient.

The results may show that the ducts are enlarged, which may indicate the ducts are blocked. The blockage may be caused by scarring or stones. It may also indicate cancer in the bile ducts, liver, pancreas, or region of the gallbladder.

See also:

• Blocked bile ducts
• Cholangitis(infection in common bile duct)

There is a slight chance of an allergic reaction to the contrast medium (iodine).

There is a slight chance of excessive blood loss, blood poisoning (sepsis), and inflammation of the bile ducts.

This test has been mostly replaced by an endoscopic retrograde cholangiopancreatography (ERCP) test. A PTCA may be done if an ERCP test cannot be performed or has failed.

A magnetic resonance cholangiopancreatography (MRCP) is a newer, noninvasive imaging method, based on MRI. It provides similar views of the bile ducts, but is not always possible to perform.

It is caused by a natural gas that disturbs their stomach, they just let out the breakwind.

There are many other reasons for becoming gassy and bloated such as eating foods that cause gassiness and bloating, not properly combining foods, or gulping air while you're eating, but the vast majority of gas is produced by bacteria in your gut.

The whole story of what's going on is a combination of loss of digestive powers, the bacteria in your gut, and the types of foods you decide to put into your mouth. While it might feel that these changes have occurred quickly, in most people they have happened slowly over time as their body changes and ages.

From the Puristat website (see related link).

Tenesmus involves constantly feeling the need to empty the bowels, along with pain, cramping, and straining.

Pain - passing stool; Painful stools; Difficulty passing stool

Tenesmus usually occurs with inflammatory diseases of the bowels. These diseases may be caused by an infection or other conditions.

People with tenesmus feel as though they need to pass stool. Although they strain, they pass little stool.

• Anorectal abscess
• Colorectal cancer or tumors
• Crohn's disease
• Infection of the colon (infectious colitis)
• Inflammation of the colon or rectum from radiation (radiation proctitis or colitis)
• Inflammatory bowel disease (IBD)
• Ulcerative colitis

If you feel that you are constipated, try to increase your fluid and fiber intake.

Contact your health care provider if you continue to have symptoms of tenesmus that are constant or come and go.

Also call if you have:

• Abdominal pain
• Blood in the stool
• Chills
• Fever
• Nausea
• Vomiting

These symptoms could be a sign of a disease that might be causing the problem.

The doctor will examine you and ask questions such as:

• Time pattern
  • Did this develop recently?
  • Is it the first time you have had tenesmus?
  • Does the feeling come and go, or is it constant?
• Symptom history
  • Do you have a constant need to empty the bowels?
  • Do you have abdominal pain?
  • Do you have cramping?
  • Do you have a persistent feeling of straining?
  • Do you have diarrhea or vomiting?
  • What other symptoms do you have (such as blood in stool, fever)?
• Dietary history
  • Have you eaten anything unusual or uncooked?
  • Have you been at a picnic, gathering, or similar event recently?
• Other
  • Have you had any medical problems in the past?
  • Have any other people in your family or social group experienced similar problems?

The physical examination may include a detailed abdominal examination. A rectal examination-- and prostate check for men -- is performed in most cases.

Tests that may be done include:

• Colonoscopy to look at the colon and rectum
• Complete blood count (CBC)
• CT scan of the abdomen (in rare cases)
• Electrolytes
• Stool cultures
• X-rays of the abdomen