Why am I experiencing weight loss and loss of appetite at 80?

Hello,

Welcome to icliniq.com.

Thank you so much for sharing your concern with me.

An 80-year-old male presenting with chronic loss of appetite, significant weight loss, and intermittent diarrhea in a flare-remission pattern raises concern for an underlying chronic inflammatory or organic gastrointestinal pathology rather than a functional disorder. A prior diagnosis of “colitis” is nonspecific and requires further characterization.

Differential diagnoses in your case include:

1. Inflammatory bowel disease (particularly late-onset ulcerative colitis).
2. Microscopic colitis (which is common in the elderly and may be drug-related).
3. Chronic infections.
4. Malabsorption syndromes.
5. Pancreatic insufficiency.
6. Importantly, colorectal malignancy.

Pradaxa (dabigatran etexilate) increases bleeding risk but does not account for these symptoms.

Your evaluation should not be delayed. Colonoscopy with ileoscopy and biopsies is recommended for you to define the type of colitis and to rule out malignancy. The initial workup should include:

1. Complete blood count (CBC).
2. C-reactive protein (CRP).
3. Erythrocyte sedimentation rate (ESR).
4. Liver function tests (LFTs).
5. Albumin levels.
6. Iron profile.
7. Vitamin B12 levels.
8. Stool examination (routine and occult blood).
9. Fecal calprotectin.
10. A CT (computed tomography) scan of the abdomen may be required if red flag features persist.

Management depends on the underlying cause. If inflammatory colitis is confirmed, treatment with 5-ASA (5-aminosalicylic acid) or Budesonide may be indicated. Microscopic colitis typically responds well to Budesonide. Nutritional rehabilitation is essential, including a high-protein diet and appropriate supplementation.

Given your age and weight loss, malignancy must be excluded at an early stage, as delays in diagnosis can be harmful.

Hope I have addressed all of your queries and concerns. Do follow up whenever needed.

Thank you.

Hello,

Welcome back to icliniq.com.

You are taking the right step by planning a colonoscopy.

Nutritional rehabilitation refers to rebuilding your strength, body weight, and protein stores that may have been lost due to chronic illness. It is advisable to start with small, frequent meals rather than large portions, focusing on easily digestible, high-calorie, and high-protein foods such as rice, soft chapati, eggs, curd, yogurt, boiled chicken, fish, and lentils. Including calorie-dense foods like bananas, potatoes, and small amounts of healthy fats such as ghee or oil can help improve energy intake.

If your appetite remains poor, oral nutritional supplements, including protein powders or ready-made nutrition drinks, may be beneficial. It is also important to check for deficiencies such as iron, vitamin B12, and vitamin D, and to correct them if they are low, while maintaining adequate hydration.

Regarding the possibility of infection, contaminated water can lead to infections such as E. coli (Escherichia coli), Salmonella, or Giardia lamblia, but these typically cause more acute symptoms like sudden diarrhea and fever rather than symptoms that persist over several years.

However, chronic parasitic infections such as Giardia can occasionally present with prolonged symptoms and weight loss. Therefore, a stool examination for ova, parasites, and infections is a reasonable step.

Testing your water supply may be considered if there is a known contamination issue, but it is more important to proceed with appropriate medical evaluation, including stool tests and colonoscopy. Overall, infection alone should not be assumed; given your age and weight loss, a thorough evaluation is essential.

I hope this helps you.

Thank you.