After treated from H.Pylori,The patient has recurrent stomach pain,with constant bloating and bleaching.. he is feeling nauseous all of the time and loss of appetite and lost 4 Kilo grams in one month.I ordered A CT scan on the abdomen with oral contrast, which showed no abnormality or evidence of tumors.What can be causing the loss of appetite and stomach gases all the time?
A 18 years old male,Suffering from stomach pain,Gerd and Acid reflux, Did an endoscopy last year which showed insignificant inflammation and H.pylori infection and weak lower esophageal sphincter.treated from H.pylori successfully.After one year recurrent of stomach pain.but no evidence of H.Pylori as I did Stool antigen test,and stool culture, which was clear.apart from intermittent passage of e.histolytica cysts.The patient has slightly elevated Calprotectine and slightly elivated Triglycerides,Serum Cholestrol and Lipase.But normal blood picture and NORMAL Thyroid function, and Liver,Kidney functions.The Patient is anxious and from the way he speaks i think he could be having obsessive compulsive disorder,could this be cause gastrointestinal gases? The patient is complaining that symptoms are interfering with daily life activities.Bad breath all the time.
Purpose of case discussion
Diagnostic dilemma: "What are the next steps for evaluation?"