Hello Doctor, Please advise, I was infected 3 months before, previous tests were negative, few days after exposure as part of acute infection Loss of apetite was there. Now this is my third month appetite is not improving rather it is worsening with mild aches, distress and loose stools while consuming milk and other fatty foods. I lost 2 kilos also. Is it possible GI problems can be a part of OIs. What shall I do to improve this situation? TY Blazan

A few things come to mind...

You mention opportunistic infection and specifically problems with fats and dairy foods. Infections of the gut can temporarily make fats and lactose-containing foods difficult to tolerate. The quick result a dose of dairy foods in the case of lactose-intolerance includes cramping and watery stools. Fat intolerance can also cause deep cramping and stools that tend to float (and are often pretty smelly).

If you don't eat much, your appetite can adapt by decreasing. In addition, your appetite can be down anyway if you have an acute infection. In such instances you will still need to eat. It is important to keep your gut stimulated or it could get worse.

I would suggest talking to a dietitian about a low-residue diet (one that contains less fiber, fat, and dairy) while this problem persists. A dietitian can also help you to plan routine meals/snacks to make sure that you get in enough while your appetite is low. You will need to eat to stimulate your appetite.

As your appetite recovers, it will be worthwhile to get back to a less restrictive diet and to see if lactose and fats are really a problem for you. If so, lactose-reduced products and lower fat foods may become your preferred choices.

Your doctor and dietitian can also recommend things like lactase enzyme products (over the counter) and pancreatic enzyme products (prescription) to improve your tolerance of lactose-containing and fatty foods.

Best wishes!