### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My husband has had left flank pain for 4 or 5 years, which now travels across the front of the abdomen. He also lost 40 pounds unintentionally in the last year or two. He also has fatigue, and his blood pressure is getting lower, He had an atrial septal defect (3 holes) repaired about 6 years ago and was put on blood pressure medication to slow down his heart. My husband cut the atenolol in half within the last year. He had a kidney repair 36 years ago for because of a congenital anomoly where the kidney was not draining into the ureter because the connection was too small. His kidneys have been checked (left one only functions at 20-30%) and was told they are okay. He has had a colonoscopy, x-rays, MRI, CT scan etc, and many lab works done. They cannot find anything. He looks as though he is withering away. He is 6 feet 1 inches and used to work hard to keep his weight just under 200 pounds, and he now weighs 166 pounds. It started with the abdominal pain and the other symptoms are now getting worse. Could this be some endocrine type of disorder? He had a recent AM cortisol done which was okay, but he had it repeated today. Very frustrated!! He has also had a metal-on-metal hip placed 6 years ago. It doesnt seem to bother him very much, just on and off sometimes. Could this be the metal getting into his system? My husband still feels as though there is something wrong with kidney.

### output:

Hi ! Losing 40 pounds unintentionally is of course worrisome. When was his colonoscopy done ? If it was long back, then I think he should get it repeated. Was any biopsy done at that time or not ? If not, then you may discuss with your gastroenterologist for it during the repeat colonoscopy. Many times inflammatory bowel disease does not get diagnosed for a long time unless biopsy is done and this could be a reason for the weight loss and pain in abdomen. He should continue with his antihypertensive medications. If there is no blockage in the pelvi-ureteric system after the operation for kidney, then nothing much to worry from that angle, but if there is a blockage persisting, then it could also give rise to the pain in flank. It does not seem to be related to any endocrine system. You can discuss with your doctor for a CT Scan or a PET scan if nothing is conclusive based on the weight loss, which is significant. I wish your husband an early recovery.