Q: My wife is 60 years old. She had quite a few operations done in her life. Hysterectomy, cataract, removal of gall bladder due to stones and now she is on the border line of glaucoma. A recent eye pressure check-up says its normal. She has undergone tremendous weight loss in last 7-8 months. She was 60 kg and is 45 kg now. All blood tests abdominal ultrasound, thyroid show no abnormality. She has lost her appetite and consequently has low haemoglobin 9.5. She is not a vegetarian but does not like meat. What can she do to increase her weight?

A:The leading causes of unintentional weight loss in elderly patients are: Depression, Cancer (lung and gastrointestinal malignancies), Heart disease and benign disorders of the gastrointestinal tract. One should exclude the possibility of drug(s) ingestion that may be causing nausea & vomiting, dysphagia, and anorexia. In about 25% cases no cause may be found. Investigations should include (after physical examination): - testing for occult blood in stool, urine examination, complete blood count, liver and renal function tests and an ultra-sensitive thyroid-stimulating hormone test. Upper gastrointestinal studies may be indicated. Therapy is based on treating underlying cause(s) and providing adequate nutritional support. One should pay attention to the patients environment and interest in and ability to eat food.