Malabsorption, especially celiac sprue but many other kinds, usually comes with gastrointestinal symptoms, but not always. Chronic infections like tuberculosis and HIV can hide and need to be looked for. Psychiatric disease, especially depression, often shows up as weight loss. High thyroid levels and diabetes usually have other symptoms.
All that having been said, I still think the change in diet (less red meat, salt, sugar and dairy) absolutely could still be causing the weight to drop further. The fact that you feel well and are exercising makes diet a more likely cause than hidden disease.
The booklet on the prostate gland discusses enlargement and cancer. Readers can obtain a copy by writing: Dr. Roach — No. 1001, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DR. ROACH WRITES: In a column in August, I wrote that the cause of fecal incontinence often is not found. Many readers wrote to tell me about causes that could be looked for. Celiac sprue headed the list, but other readers mentioned lactose and fructose malabsorption, carcinoid tumor, collagenous colitis, C. diff infection, Giardia infection, sugar alcohols (such as mannitol or sorbitol), too much coffee, bile dumping and bacterial overgrowth.
Some people found relief by making changes in their diet. One approach is an “elimination diet,” removing as many possible causes as you can, then adding them back in one by one (if you have obtained relief). Grains and dairy are the most common culprits.
Some people got relief from medication. Probiotics (healthy bacteria) and prescription bile acid-binding medication (such as cholestyramine) were mentioned by many people. One person suggested physical therapy or Kegel exercises.
A group of people often has more collective wisdom than any of its individual members.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible.