abnormal eating
Introduction
Introduction Eating disorders, also known as eating disorders, medically refers to abnormal eating habits that impede the patient's physical and mental health or morbid control of body weight. A group of syndromes characterized by abnormal eating behavior as a cause. Postoperatively, it mainly includes anorexia nervosa, bulimia nervosa and neuropathic vomiting. Some people also attribute simple obesity and heterophagia to eating disorders, which are generally psychologically induced. More women than men in patients. Any disease of the body and spirit can cause changes in appetite, including loss of appetite, hyperphagia and refusal.
Cause
Cause
Appetite is a pleasant feeling for certain foods before or during eating. It is based on conditioned reflexes. Any disease of the body and spirit can cause changes in appetite, including loss of appetite, hyperphagia and refusal.
[Etiology and mechanism]
1. Physiological function of the gastrointestinal tract: feeding is the basis of gastrointestinal function. Under normal physiological conditions, people use hunger, appetite and satiety to regulate and ensure food intake. The food is chewed in the mouth and stirred with saliva, passed through the esophagus into the stomach, mixed with gastric juice containing stomach acid and pepsin for preliminary digestion, and then into the small intestine, in alkaline intestinal fluid, in pancreatin, bile and various Under the full action of the hormone, digestion and absorption are carried out, and finally the food residue is concentrated into feces and discharged through the rectum.
2. Feeding center: Food is one of the high-level activities. After eating, hunger disappears. But for delicious food, it can still cause appetite. It is known that the regulation of the hypothalamus and feeding plays an important role. When the ventral region of the hypothalamus is destroyed, it will cause the animal to overeat and lead to obesity. Destruction of the lateral area will cause refusal and refusal to drink, and will be indifferent to food until hunger. Conversely, stimulation of the ventral and lateral regions of the hypothalamus results in the opposite of damage.
3. The neurobiochemical mechanism of feeding: The study found that the function of the central nervous system affects the feeding function. The norepinephrine is injected into the lateral region of the hypothalamus of the mouse, and begins to eat after 5 to 10 minutes, lasting 20 to 40 minutes. It can also make a full-fledged monkey eat further. Peripheral injection of serotonin can reduce the food intake of rats, and direct injection of serotonin into the ventricles of the ventricles or hypothalamus can inhibit the feeding of rats. The specific mechanism is still unclear. Acetylcholine promotes animal feeding through some structure of the limbic system. When blood sugar is high, it also has an inhibitory effect on food intake.
4. The regulation of appetite in the gastrointestinal tract: the filling of the stomach or the degree of contraction is an important feedback to the appetite. When the stomach is empty, the contraction is enhanced. People have hunger and appetite. When the food is filled, the contraction is weakened. People have a feeling of fullness and loss of appetite.
5. The influence of psychological factors on appetite: The gastrointestinal tract is dominated by autonomic nerves. The psychological and physiological communication and regulation are through intermediaries such as autonomic nerves, hormones and neurotransmitters. When the spirit is happy, the appetite increases, and the appetite decreases when the depression is depressed.
Examine
an examination
Related inspection
Esophagography esophageal barium meal perspective
The main symptoms that may be included in eating disorders:
Appetite hyperactivity, overeating, bulimia (too much to eat), food intake increased significantly, mostly multiplied, with or without weight gain. Loss of appetite, anorexia (too little to eat), decreased appetite, and reduced food intake. Refusal to eat, normal appetite and refuse to eat any food. Vomiting after taking food, taking laxatives or ruminating.
Phobias for specific foods are sometimes classified as eating disorders. Physiologically, anorexia and eating disorders can lead to malnutrition and even death. Long-term intentional vomiting or the use of laxatives can damage the mouth or digestive tract. Many people with eating disorders also suffer from mental illnesses such as depression and anxiety.
Diagnosis
Differential diagnosis
First, loss of appetite
(1) Physical factors
1. Gastrointestinal diseases such as ulcer disease, gastritis, stomach cancer, etc. cause low gastrointestinal function, causing loss of appetite.
2. Central nervous system diseases such as brain tumors lead to increased intracranial pressure, loss of appetite or vomiting.
3. Metabolic diseases such as uremia, low blood in diabetes, etc. affect the eating center and cause loss of appetite.
4. vestibular dysfunction such as motion sickness, streptomycin poisoning, etc. can cause loss of appetite, nausea and vomiting, etc., which is due to the pathological excitability of the vestibular organs transmitted to the vestibular nucleus of the brainstem, and thus extended to adjacent The dorsal nucleus of the vagus nerve is caused by abnormal excitation of the vagus nerve.
5. Abdominal organ diseases such as hepatitis, biliary tract diseases, etc. can reflexively cause nausea and vomiting, loss of appetite.
6. Pregnancy can also cause loss of appetite, which may be related to increased estrogen.
(2) Mental factors
Mental stress, anxiety, and fear can cause loss of appetite, and appetite can be restored after the mental factors are removed. There is also a loss of appetite in neurasthenia and depression. Anorexia nervosa refers to a group of diseases caused by mental factors caused by obvious loss of appetite and weight loss. Common in adolescents, especially women, pre-existing personality is mostly cautious, stereotyped and compulsive.
(3) Drug factors. Drugs such as morphine and codeine can directly act on the center and cause nausea and loss of appetite. Alcohol, erythromycin, sulfa antibiotics and the like act on the gastrointestinal tract to cause nausea and loss of appetite.
Second, the appetite
(1) Physical factors
1. Endocrine diseases: such as hyperthyroidism, increased metabolism, increased appetite, and increased food intake, but the body weight does not increase.
2. Subthalamic lesions: The tumor or inflammation in the lower part of the thalamus affects the feeding center and can cause appetite hyperactivity and weight gain.
(2) Mental factors
1. Mania: As the patient's excitability increases, the movement increases, the consumption increases, and the appetite increases. In addition, other symptoms of mania can be seen.
2. Schizophrenia: These patients may be exposed to a large number of foods at a time, subject to hallucinations or delusions. It is not difficult to identify according to the course of the disease and careful mental examination.
3. kleine-levin syndrome: manifested as paroxysmal sleep and bulimia, the attack usually lasts for several days, the patient wakes up to eat, eats a lot, eats and sleeps, the weight is often significantly enhanced, more common in male adolescents.
4. Mental retardation: such patients may have excessive appetite and overeating. Due to its intellectual barriers, self-control ability has declined and instinctive activities have progressed. Intelligent testing can confirm the diagnosis.
Third, antifeeding
(1) Schizophrenia: Under the control of delusions and hallucinations, there may be antifeeding behaviors. For example, a patient who is convicted of suspicion is afraid that people will poison the meal and refuse to eat.
(2) Depression: The anti-feeding behavior may occur due to the concept of suicide. There is also a refusal to eat during the stupor. In addition, there are other symptoms of depression, such as depression and slow thinking. After the treatment of depression improved, the anti-feeding behavior also improved.
(3) Hysteria: Rapid onset after stress, antifeedant behavior may occur, and it is not difficult to diagnose according to the course of disease and pre-existing personality.
(4) Disorders of consciousness: Various causes of disturbance of consciousness may lead to refusal to eat, and careful examination may reveal corresponding positive signs.
The main symptoms that may be included in eating disorders: excessive appetite, overeating, bulimia (too much to eat), a significant increase in food intake, mostly multiplied, with or without weight gain. Loss of appetite, anorexia (too little to eat), decreased appetite, and reduced food intake. Refusal to eat, normal appetite and refuse to eat any food. Vomiting after taking food, taking laxatives or ruminating. Phobias for specific foods are sometimes classified as eating disorders. Physiologically, anorexia and eating disorders can lead to malnutrition and even death. Long-term intentional vomiting or the use of laxatives can damage the mouth or digestive tract. Many people with eating disorders also suffer from mental illnesses such as depression and anxiety.
