Abdominal pain and unintentional weight loss can be alarming. While weight can fluctuate, losing 10 or more pounds, or more than 5 percent of your body weight, without changes to eating or exercise habits warrants attention.
This article explores the potential reasons behind stomach cramps and weight loss, focusing on digestive disorders and other medical conditions. It aims to provide a comprehensive overview of the causes, symptoms, and available treatment options.
Understanding Abdominal Pain
The abdomen houses many vital organs, including the stomach, liver, and intestines. Abdominal pain can manifest in various ways, such as:
- Sharp pain
- Crampy pain
- Burning sensations
- Stabbing pain
Digestive Disorders Causing Weight Loss
Several digestive diseases can lead to weight loss, impacting your self-confidence and overall well-being. Reasons for weight loss due to digestive disorders may include malabsorption of nutrients, inflammation, and difficulty digesting food. Common symptoms of digestive disorders include diarrhea, abdominal pain, bloating and gas, constipation, vomiting and nausea, and fatigue. Here, we examine some of the most common culprits:
1. Crohn's Disease
Crohn's disease is an inflammatory bowel disease (IBD) affecting the digestive tract. It causes inflammation of the digestive tract lining, leading to abdominal pain, severe diarrhea, fatigue, and weight loss. The exact cause remains unknown but is believed to stem from a combination of genetic and environmental factors.
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- How it causes weight loss: Crohn's disease can lead to malabsorption of nutrients due to small intestinal inflammation.
- Symptoms: Abdominal pain, severe diarrhea, fatigue.
- Treatment: Treatment depends on the severity of symptoms and the type of Crohn's disease. Options include anti-inflammatory drugs, immunosuppressants, antibiotics, and biological therapies.
2. Diabetes
Diabetes is a chronic condition affecting the body's sugar processing. It occurs when the body doesn't produce enough insulin or cannot use insulin properly.
- How it causes weight loss: Diabetes can cause increased urination, leading to fluid and electrolyte loss. Also, people with diabetes suffer from insufficient insulin, preventing the body from getting glucose from blood cells to use as energy.
- Symptoms: Frequent urination, thirst, fatigue, and unexplained weight loss.
- Treatment: Treatment depends on the type of diabetes and the severity of the symptoms. Options include insulin, oral medications, and injectable medications.
3. Hyperthyroidism
Hyperthyroidism, or overactive thyroid, is a digestive disorder where the thyroid gland produces too much thyroxine hormone.
- How it causes weight loss: Excessive thyroxine speeds up metabolism, leading to weight loss, even with increased appetite.
- Symptoms: Weight loss, increased appetite, rapid heartbeat, sweating, and anxiety.
- Treatment: Treatment options range from medication (thioamides) to radiotherapy (radioactive iodine treatment) to surgery, depending on the condition’s severity.
4. Peptic Ulcers
Peptic ulcers are sores in the stomach lining, small intestine, or esophagus, often due to infection with Helicobacter pylori (H. pylori) bacteria.
- How it causes weight loss: The condition may cause obstruction or blockage of food passage through the digestive tract.
- Symptoms: Burning stomach pain, bloating, heartburn, nausea, and weight loss.
- Treatment: Treatment includes antibiotics to kill H. pylori, medications to reduce stomach acid production, and lifestyle changes like quitting smoking and reducing alcohol consumption.
5. Celiac Disease
Celiac disease is an autoimmune disorder affecting the digestive system, caused by intolerance to gluten, a protein found in wheat, barley, and rye.
- How it causes weight loss: Gluten intolerance leads to difficulty digesting food and malabsorption of nutrients, or malnutrition.
- Symptoms: Diarrhea, abdominal pain, bloating, fatigue, and weight loss.
- Treatment: The only treatment option is a strict gluten-free diet, avoiding all foods containing wheat, barley, and rye.
Pancreatic Cancer
The signs and symptoms of pancreatic cancer include indigestion, pain in your tummy or back, changes to your poo, losing weight without meaning to, and jaundice.
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Common Signs and Symptoms of Pancreatic Cancer
Indigestion causes a painful, burning feeling in your chest, upper tummy or throat. It can also leave a bitter, unpleasant taste in your mouth.
Tummy pain or back pain, or sometimes both, are common symptoms of pancreatic cancer. The pain may start as general discomfort or tenderness in the upper tummy area and spread to the back.
Pancreatic cancer can cause diarrhoea (runny poo) and constipation (when you find it harder to poo). If you have diarrhoea for more than 7 days and you don’t know why, contact your GP or call NHS 111. Your GP may do blood and poo tests. If you have lost weight and have diarrhoea or constipation, your GP should refer you for an urgent scan.
Losing a lot of weight without meaning to can be a symptom of pancreatic cancer. The pancreas plays an important role in digesting food and controlling your blood sugar levels. Pancreatic cancer can affect this and cause weight loss.
Signs of jaundice include yellow skin and eyes. Yellow skin may be less obvious if you have brown or black skin, but you may notice the white part of your eyes looks yellow. Some people also feel sick, lose weight, lose their appetite or feel tired.
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Pancreatic cancer can cause jaundice by blocking the bile duct. The bile duct is the tube that takes bile from the liver to the duodenum (the first part of the small intestine). Bile is a fluid made by the liver to help digest food.
Losing your appetite and not feeling like eating can be a symptom of pancreatic cancer, but it can also be caused by other things. Speak to your GP if you have lost your appetite and you don’t know why.
Diabetes is a condition where the amount of sugar in the blood (blood sugar level) is too high. The pancreas produces a hormone called insulin, which helps to control the blood sugar level. Pancreatic cancer can stop the pancreas producing enough insulin, which can cause diabetes.
It’s common for pancreatic cancer to cause problems with eating and digesting food. Symptoms of this include feeling full up quickly when you eat, a bloated tummy, lots of wind, and burping. But these symptoms can be common problems and aren’t usually due to pancreatic cancer.
Pancreatic cancer can cause blood to form clots in a vein. This is known as deep vein thrombosis (DVT). Blood clots often happen in your lower leg, but they can happen anywhere in the body.
Fatigue is when you feel very tired all the time, even if you rest. It can be exhausting and draining.
Less common symptoms of pancreatic cancer include a fever, shivering, and generally feeling unwell or not quite right. Some people also feel like they can’t swallow their food properly. This may be because the cancer can make you feel full quickly when you eat. Depression and anxiety without any obvious cause may also be a symptom.
When to Seek Medical Attention
If you experience any symptoms associated with digestive disorders or unexplained weight loss, seeking medical help is crucial. It is especially important to seek immediate medical attention if you’re vomiting blood or observe blood in your stool. Also, old blood in the vomitus can resemble coffee grounds. And sometimes stool may not contain red blood but may be maroon or black and tarlike. Seek immediate medical attention if your pain suddenly worsens. And make an appointment to see your doctor if:
- You have a fever greater than 100°F (37.7°C)
- Your appetite doesn’t return in three to five days
- Your stomach pain lasts longer than a week
- Your stomach pain gets worse
A healthcare provider can diagnose the condition and recommend a tailored treatment plan.
Diagnostic Tests for Unexplained Weight Loss
A healthcare provider may order specific medical tests based on your symptoms, family history and other factors. For example, if you have symptoms of a peptic ulcer, your provider may recommend an upper endoscopy. Other tests may include:
- Blood tests: Blood can show signs of certain health conditions like diabetes, celiac disease and infections. It can also give your provider information about how your metabolism, thyroid and adrenal glands are working.
- Cancer screening tests: If your provider wants to rule out cancer, you may need screening or imaging tests. For example, a colonoscopy can detect colorectal cancer.
- Imaging tests: Tests like an MRI (magnetic resonance imaging) or CT scan (computed tomography scan) can provide detailed images of your organs, like your brain, heart, lungs and abdominal organs. You may need one of these tests if your provider wants to rule out tumors or diseases that may be visible on these scans.
- Urine test: A urinalysis can provide information about your kidneys and bladder, including certain health conditions and infections.
Treatment Options
Abdominal pain and unintentional weight loss treatments can vary because their causes vary. Your doctor will try to determine the underlying cause. However, in the meantime, they may prescribe medication to help control your symptoms. If a virus is causing your symptoms, antibiotics won’t improve your symptoms because antibiotics are not effective against viruses. If your abdominal pain and unintentional weight loss are due to a parasite, your doctor will determine the appropriate medication to kill the parasite. Counseling can improve symptoms caused by stress and anxiety. Getting more rest and exercise may also help.
Home Management and Prevention
If you’re losing weight and don’t know why, don’t try to treat it at home. See a provider to find out the cause so you can receive the treatment you need.
Many of the conditions that lead to unexplained weight loss can’t be prevented. But there are some steps you can take to help prevent some of them, including:
- See your primary care provider for an annual physical exam.
- Get poked and checked! Be sure that you receive all recommended vaccines and cancer screenings.
- Take prescription medications as instructed. Reach out to your healthcare provider if you experience any side effects, including changes in appetite or weight after starting a new medication.
- Take good care of your teeth and gums.
Abdominal pain can cause you to not feel like eating or drinking. Drink small sips of water or a beverage that contains electrolytes, such as Pedialyte, to avoid becoming dehydrated. Eating several small meals instead of fewer larger ones can help. Avoid high-fat, greasy foods, such as pizza or french fries. They can make your symptoms worse. Instead, try eating:
- Broth-based soups
- Cooked vegetables and fruits
- Gelatin
- Mashed potatoes
- Peanut butter
- Protein supplement shakes
- Pudding
- Toast
These foods can keep your stomach settled and prevent additional weight loss.
Typically, you can’t prevent abdominal pain and unintentional weight loss. However, practicing good hand hygiene habits, such as frequent hand washing, can help to prevent infectious causes. In general, prolonged abdominal pain associated with weight loss is related to a medical condition that needs to be diagnosed and treated by your doctor.
A Case Presentation of Crohn’s Disease
A previously healthy five-year-old boy presented with a three-month history of intermittent abdominal pain. His growth had plateaued, with his weight crossing from the 75th percentile to below the 50th percentile and height crossing from the 90th percentile to the 75th percentile. He was found to be anemic with a hemoglobin of 72 g/L. He was started on iron supplementation. His abdominal pain continued on and off over the next three years. An increase in the pain and frequency of his bowel movements along with acute weight loss brought him back for medical attention at the age of eight years. The abdominal pain occurred before or during stooling, with some relief afterward. He was having five mucousy, bloody bowel movements per day and two to three per night. Tenesmus and urgency were present. He had intermittent fevers and nausea with occasional vomiting. On examination he appeared thin, pale and unwell. His weight was 22 kg (25th percentile) and height was 132 cm (50th to 75th percentile). Digital clubbing was present. Several oral aphthous ulcerations were present. His abdomen was soft with no distension, tenderness, organomegaly or masses. Bowel sounds were present.
Laboratory investigations revealed a hemoglobin of 100 g/L, a mean corpuscular volume of 70 fL, an albumin of 28 g/L and an erythrocyte sedimentation rate of 58 mm/h. Platelet count, international normalized ratio, partial thromboplastin time and liver enzymes were normal. An upper gastrointestinal (GI) series with small bowel follow through revealed a diseased terminal ileum with luminal narrowing and a cobblestoned mucosal appearance. Upper endoscopy showed erythema and aphthous ulceration of the esophagus and duodenum. The colonoscopy demonstrated severe erythema, edema, friability and ulceration. The clinical presentation, laboratory and endoscopic findings were consistent with Crohn’s disease (CD). He was treated with prednisone 25 mg daily for the inflammatory component and metronidazole 125 mg twice daily for the perianal involvement.
The hallmark of inflammatory bowel disease (IBD), which includes both CD and ulcerative colitis (UC) is GI symptoms, including abdominal pain and diarrhea, which may or may not be bloody. Abdominal pain is usually more severe in CD than in UC. Systemic symptoms, including fevers, decreased appetite, weight loss or failure to thrive, may occur in both diseases but are more prominent in CD. Other intestinal symptomatology may include nausea, vomiting, oral ulcers, perianal disease and constipation. CD can be more difficult to diagnose than UC because the GI symptoms may be more subtle while the systemic symptoms predominate. A plateau in linear growth, delayed puberty, perianal lesions and finger clubbing are clinical signs of CD that are often overlooked.
Extraintestinal manifestations of IBD occur in 25% to 30% of cases and include erythema nodosum, pyoderma gangrenosum, sclerosing cholangitis, arthritis, uveitis, nephritis and pancreatitis. Laboratory findings are nonspecific and include anemia, hypoalbuminemia and elevated acute phase reactants. The presence of any of these laboratory abnormalities along with GI symptoms or weight loss should raise suspicion of IBD. Anemia is usually secondary to iron deficiency and GI blood loss, but ferritin may be normal or high because it is an acute phase reactant.
Given the wide spectrum of clinical presentations of IBD, other disorders that may have similar presentations must be considered. Chronic diarrhea has a wide differential diagnosis. If growth is preserved, infectious diarrhea, toddler’s diarrhea and lactase deficiency are possible diagnoses. When growth parameters are affected, etiologies to be considered include intestinal causes (eg, celiac disease and milk protein allergy), pancreatic insufficiency (eg, cystic fibrosis), metabolic causes (eg, thyrotoxicosis), immune defects or neoplastic disease. Abdominal pain is very common in childhood and the clinician must determine when further investigation is necessary.
Once the diagnosis of IBD is suspected, a full assessment of the bowel must be undertaken. The small bowel is most commonly evaluated by an upper GI series with small bowel follow through. The definitive diagnosis requires direct visualization of the bowel by endoscopy with biopsy. Classic findings of CD include deep penetrating or aphthous ulcers, cobblestoning and skip lesions. Noncaseating granulomata are seen in approximately 30% of cases. The small bowel, particularly the terminal ileum, is frequently involved while the rectum is spared. Perianal involvement with skin tags, fissures, fistulae or abscesses are also features of CD. In UC, the endoscopic findings are limited to the colon, with continuous nongranulomatous inflammation beginning at the rectum and extending proximally for variable distances.
Primary therapy for moderate to severe IBD often requires corticosteroids. Other treatment options include enteral nutrition, 5-aminosalicylic acid and antibiotics. Immunomodulatory medications (eg, azathioprine, methotrexate, cyclosporine, tacrolimus) and biological therapies (eg, infliximab) are also used in more severe or refractory cases for the purpose of remission induction and maintenance. Therapy is guided by the severity and distribution of disease. Surgery may be curative in UC, but it is useful only as an adjunct to therapy in CD.