Brief Answer:
details as follows..

Detailed Answer:
Hello XXXX, Welcome to HCM,
I've gone through your query in details and understand your concern for your mom..

Sorry for the delay in response to your query, it doesn't happen like this usually..

So to recapitulate, your mom, 59/F who's a known case of hypertension and diabetes and chronic depression (on treatment), initially had problems with gastritis and being put on various PPI/antacids and probiotics..

But the weight loss over this time-span is definitely quite concerning..

On-off recurrence of infection can cause this too..however the proper cause of infection has to be diagnosed at first (which I believe is done already as treat infection as well as bladder infection/ cystitis)..

Cause of anemia can be iron deficiency as well as chronic infection/disease which needs thorough investigations..(yes dark stool can be due to iron supplements but it has to be established by proper stool microscopy for OBT..)

The high platelet count can be due to persistent infection but can also be due to several other causes like some specific. type of anemia/blood disorders, chronic hepato-renal failure etc., which needs thorough investigations..

Good that you've a date for the Gastro and/ colonoscopy, it'll give some insight to it..

So far, from your description of the Ultrasound, it seems there's fluid accumulation in side the abdominal peritoneal cavity (ascites) and there's signs chronic liver disease (cause undetermined till now), as well as small spleen and Gr III hydronephrosis (cause to be determined - obstructive uropathy most likely- means there's either some mass/lesion/stone which is obstructing the drainage of urine from the left kidney, which is causing the swelling, needs further evaluation)..

Yes, the condition is multi-factorial, and severe enough to make any individual bed-ridden..surgery is definitely a possibility later on, but at first the exact cause has to be determined..also, prior to any surgery, she has to be assessed for the pre-operative fitness, if cleared, then only the next step to be considered..

At first, the primary concern should be, keep her admitted in the hospital only, as this is a complex situation with multi-factorial involvement which needs round the clock monitoring, medical supervision by specialists (mostly Gastroenterologists, GI surgeons, Internal medicine specialists) along with nursing care and other supportive measures..

Next step is to get done proper CT scan of the abdomen with preferably oral contrast (as her present condition may not be fit for I.V. contrast) along with routine CBC, LFT, Amylase, lipase, coagulation profile and KFT assessment..also Hepatitis B and C has to be ruled out..the peritoneal fluid has to be analysed further(cell type, cell count, biochemistry, culture sensitivity etc.)..

Based on the complete assessment and the results of all these studies, it'll be possible to decide if there's any acute need for surgical intervention or not..

As of now, she needs prolonged investigations for diagnosis if this a single ailment or a combination of ailments which is affecting her health..proper antibiotic prophylaxis is equally important at the same time..

Let me know if any of those above mentioned investigations done so far, if yes, simply upload/attach them at the Reports section so that I can take a detailed look at it to guide you more specifically..also, if your having any present Course of treatment of her in the hospital (it's a detailed documentation provided by the hospital authority to the keens upon request or at the time of discharge), please upload it here so that i can take a detailed look at it..

Let me know how she stays in the due course..any further queries are most welcome..

Take Care
Kind Regards

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