Dr. R. Rahul
General Practitioner
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Patient's Query
Hello doctor,
My son is 22 years old. One and a half years back, he had IBS and piles with loss of weight. CT showed enlarged lymph nodes in the intestine. Neddle biopsy of the same was found to be reactive. However, last year, weight is not improved but reduced (62 to 57 kg). Appetite fluctuates with vomiting sometimes, but he is fully active. Recent CT shows lymph nodes are still there with no change in size as seen last year. Stools calprotectin level is higher than 200. Doctors are not yet concluding, except the above no other symptom. Please advise.
Hi,
Welcome to icliniq.com.
I went through your son's medical history and would like to advise the following.
If the diagnosis is already made of IBS and nothing else, then we need to see this as a case of IBS (irritable bowel syndrome).
Weight loss in spite of eating well could be of some concern and should be investigated. It could be because of IBS per say or malabsorption due to IBS.
Other is we need to rule out any cancer or tumor for which a PET (positron emission tomography) scan and tumor marker tests specific to the intestine should be done.
Having said that, I would like to stress the fact that IBS is a very difficult disease to get cured. You require a lot of time and lifestyle modifications to get back on track.
I hope this helps.
Patient's Query
Thank you doctor,
His appetite is not always good. He is not eating as he used to be. This may be one of the possible reasons for weight loss. Lymph nodes were seen to be reactive in needle biopsy. Please suggest medicines for infected lymph nodes and increased calprotectin levels in stools.
Hi,
Welcome back to icliniq.com.
Lymph nodes reactive is common in IBS (irritable bowel syndrome). It is the change which the nodes go through and high levels of calprotectin also suggest that there is inflammation of the intestines secondary to IBS or other things.
For appetite, you can give him syrup Aptisyp (appetite stimulant) 10 ml 20 minutes before food. But for IBS with decreased appetite and weight loss, we should rule out cancer and any tumors of the gut. As said in my earlier post, a gastroenterologist would be an ideal person to follow up and clear all the doubts.
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General Practitioner
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