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Dr. Charles
Dr. Charles, Doctor
Category: Health
Satisfied Customers: 7192
Experience:  Internal medicine specialist
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18 y/o male. Unexplained wt loss, has had blood tests and

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18 y/o male. Unexplained wt loss, has had blood tests and stool tests, EGD and Colonoscopy, negative except, EGD showed esophageal ulcer. Had GERD induced asthma as a child. Wt loss can come and go but he has never reqained back to original wt and now has frequent loss of appetite, can't sleep at night, abdominal pain and nausea. Any suggestions, Prilosec x 5 weeks doesn't seem to be helping.
Dear customer,
I am Dr.Charles and I’m happy to help with your question today. I need the following information from you, so that I can provide you the best answer:
What is your height & present weight?
Is there any pain in abdomen?
Ever blood in stool?
I am online and is waiting for your reply.
Kind Regards-
Customer: replied 4 years ago.

6'3" 187lbs. Last Oct 2012 was a muscular build of 205lbs, hard working country kid who works on small family farm, haying square bales of hay as mostly a one man team, picking up out of field, hauling, unloading, selling, loading during summer mos. Lost down to 184lbs, before he made any complaints to mother. Spoke to family dr who thought since symptoms had abated to just monitor weight. Maintained weight but occasionally didn't feel well, then this Aug/Sept lost down to 174lbs, has stool tests -- all negative for blood or ova and parasites. Denies blood in stool. Has a brother who developed DM ! @ age 21, and has uncle w/ IBS and niece w/ Celiac disease. Blood tests for Celiac were neg - no biopsies done. Abd U/S and Small Bowel Series were negative. Extensive blood tests have been neg. This kid is a good kid, was a Senior in HS w/ good grades last year, this year College student, started out full time, but at parent's request he take it easy until this is figured out has gone part time. Goal is to be a mechanical engineer.

Dear Theresa
Thanks for the valuable info you had given.I’ve taken a close look at your question & the reply and come up with the following answer:
Unexplained weight loss of 10 pounds (4.5 kilograms) or more,weight loss of more than 5 percent of your body weight, or persistent weight loss should be investigated.Its most common causes are:gastric/esophageal ulcer,chronic infections and infestations,Depression (major depression),diabetes,heart failure,malignancy,auto immune disorders.
Esophageal ulcer seems to be the most probable cause.Unexplained weight loss and changes in appetite are also some of the rare but severe symptoms of esophageal ulcer.Research at mayo clinic states that esophageal ulcer may lead to unexplained weight loss.The pain caused by an esophageal ulcer may make it difficult or uncomfortable for you to eat and may decrease your appetite.
Although you have extensive blood tests.You need following tests if they have not been done:
-CBC(Complete blood count)
-Urine examination
-Ultrasound abdomen
-Thyroid hormone testing
-Liver function tests(LFT)
-Antinuclear antibody tests
To gain weight, you need to eat more calories than your body uses each day.Calculate how many calories you need to consume per day to gain weight.Add at least 500 calories per day to your daily requirement.You need to do this regularly.Eat 4 – 6 pieces of fresh fruit a day, and at least four tall glasses of milk.
Eat foods with high protein content such as beans, pulses and peas, and foods with high starch content such as potatoes, rice and tapioca.Avoid skipping meals.Add weight lifting to your exercise program. It helps build muscle mass.Add nuts to your diet.
All these tips will help him greatly in putting weight upto 10-15 lbs.Exact diagnosis can only be made after physical & clinical examination.So I advice you to make an appointment with your doctor for these tests & examination to know the exact cause & then treatment will be done accordingly.
Hope this helped & I had provided you an excellent service.
Your satisfaction is my prime goal and I'm happy to answer any follow-up questions you may have.Please feel free to ask if you have any other question.
Kind Regards-
Dr. Charles and other Health Specialists are ready to help you
Customer: replied 4 years ago.

Thank you for your reply. We have already had all of the tests you recommend, and they were all negative. We have ruled out all potentially serious causes and James does not seem to be depressed, nor does he thinks he feels stressed or depressed, and there is no h/o depression in the family. So other that psychiatric evaluation we have checked all other serious possibilities out and they have been ruled out.

Today we took him to a naturalist who has helped several people out w/ nutritional problems, people of all ages. This Dr feels that James' problems are parasites and claims that stool tests are never 100%. So we are going to try his treatment, as the prilosec has not helped at all. This Dr's explanations did did make a lot of sense to this nurse, who only would use such a Dr as a last resort. And even James' who went in calling him a quack, came out w/ new hope, and respect for this Dr.

Thank you for your diet recommendations, we will implement them after this other treatment.

I was very reassured by your answer that we may be on the right track and that we have ruled out the most serious problems. Thank you for your help. Theresa