Anxiety is a likely cause of 'sickness'

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DEAR DR. GOTT: I am a 47-year-old male smoker. I have a lot of stomach problems that started after a stomach virus in January 2007. I used to weigh 214 pounds but now weigh 138 pounds and am 6 feet 4 inches tall.

I have had three complete blood counts; thyroid and B-12 tests; a computerized tomography scan of my chest, stomach and pelvis; a colonoscopy; and an endoscopy. I was told I have irritable bowel syndrome, since my tests have come back normal. A nutritionist has told me that my body mass is extremely low.

My symptoms vary and can include headaches, increased urination, fatigue, lower stomach cramps, plugged ears, tender stomach, nausea, bloating, gas, loss of appetite, abdominal pain, skipped heartbeats, different bowel patterns every day and high anxiety.

I used to be a very upbeat, positive person, but now I am nervous and have many strange thoughts and behaviors. I have an extreme fear of vomiting, which sometimes causes me to miss entire meals. I drink coffee every day even if I don't eat. I have skipped lots of meals because of pain and fear, and even if I feel hungry and can hear my stomach growling, I will ignore it.

I have become a self-centered, depressed person and care only to read about what could be wrong with me.

My doctor told me that I could be ill because of my anxiety and has offered medicines to try, but I refuse them because of the possible side effects.

Could this really be IBS, or are my doctors missing something?

DEAR READER: I believe your problems can be traced back to one thing: your irrational fears and anxiety. By not eating, you have lost far too much weight and are likely undernourished, and your caffeine intake and smoking habit are not helping.

Caffeine is essentially a diuretic that could explain your increased urination. It also can cause or worsen nervousness, anxiety and palpitations. Your bowel patterns are different every day because of your inconsistent food intake. Stomach pain, bloating, tenderness, nausea and gas can be linked back to your inadequate and infrequent eating habits. After a period of not eating anything substantial, your stomach will become unable to properly digest and absorb nutrients.

Your best course of action is to seek a physician, nutritionist and therapist who can all work together to help you understand your fears, develop an appropriate eating plan and monitor you. If there were an underlying physical illness, it would have been found. Irritable bowel syndrome is unlikely, but once you are back on a normal diet, the diagnosis can be confirmed or denied.

You have essentially developed a serious eating disorder. Eating disorders are not about gaining or losing weight; they are about control, fear and other emotional and psychological factors.

You need help. Consider admitting yourself to a facility that specializes in eating disorders, where you will have access to physicians, nutritionists and therapists to help you work through this.

I am sending you a copy of my health report "Eating Disorders." Other readers who want a copy should send a self-addressed, stamped, business-size envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Always mention the title.

Gott is a retired physician and author of "Dr. Gott's No Flour, No Sugar Diet." Send questions to Dr. Gott c/o United Media

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