I have difficulty eating anything but a small amount of food, and if I do “overeat,” I vomit. I am feeling desperate. Do you have any ideas?
Dear Dr. Roach: I am a 71-year-old healthy, active woman. I normally work out six days a week and used to be in very good shape. I am having stomach issues, which caused me to lose 20 pounds since the end of December 2023. I was thin to begin with and have lost a significant amount of muscle and most of my body fat. I was diagnosed with gastric intestinal metaplasia in 2019 and was having trouble eating, but I didn’t lose any significant weight at that time.
I am seeing another GI doctor soon, but I’m not particularly hopeful. I am 5 feet, 11 inches tall, and now weigh 129 pounds. I am feeling desperate. Do you have any ideas?Weight loss can have many different causes, and it seems like your doctors have carefully looked for many of the concerning ones. Key features of your story are that you are vomiting and losing weight.
Vomiting after eating normal amounts of food is a concern for a stomach mass, but between the endoscopy and the CT scan, it should have shown up. I would be concerned about gastroparesis, where the stomach doesn’t squeeze properly. Vomiting after eating is a hallmark symptom, as is feeling very full after a little food. A gastric emptying study can confirm the diagnosis.
As far as electrolyte sports drinks are concerned, there is no reason that you need them. You are not likely to lose significant amounts of electrolytes during an hour at the gym. Endurance athletes who exercise multiple hours outside need to be mindful of electrolyte and fluid replacement, but plain old water is just fine for almost everyone else.
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