loss of appetite
Introduction
Introduction Loss of appetite refers to a significant reduction in the number of people who do not want to eat or eat due to various functional or organic diseases. The most common diseases in the clinic are gastritis and peptic ulcer. Appetite is a phenomenon of high levels of neurological activity. After birth, due to the experience and habits of eating various foods, it gradually forms a taste for certain foods. Some foods do not conform to the taste. When these foods pass through the visual, olfactory taste, etc., the brain can renew the desire for certain foods. Or aversion to certain foods. Therefore, anorexia nervosa occurs in the clinic due to mental factors. However, in normal people, if there is a serious sense of hunger, the choice of food will not be too high.
Cause
Cause
Digestive diseases:
Digestive diseases are the most common cause of loss of appetite.
(1) stomach diseases: common gastric cancer, acute gastritis chronic gastritis, duodenal ulcer with pyloric obstruction.
(2) intestinal diseases: intestinal obstruction, intestinal tuberculosis, etc.
(3) Liver diseases: common chronic liver cirrhosis and liver pain.
(4) biliary tract disease: common acute and chronic cholecystitis, cholangiocarcinoma and so on.
(5) Pancreatic diseases: common acute and chronic pancreatitis, pancreatic cancer and the like.
Systemic disease:
Common systemic diseases are:
(]) High heat caused by various reasons.
(2) electrolyte and acid-base balance disorders: such as hyponatremia, hypochloremia, hypokalemia, hyperkalemia and various causes of respiratory acid, alkalosis, metabolic causes caused by various reasons Acid and alkali poisoning.
(3) endocrine diseases: common hypothyroidism, adrenal insufficiency, hypopituitarism and so on.
(4) Others: such as severe anemia, uremia, vitamin deficiency.
Caused by drugs:
Common drugs such as aminophylline, chlorinated, digitalis, chloramphenicol, aspirin and erythromycin.
Examine
an examination
Related inspection
Gastrointestinal CT examination of gastrointestinal diseases by ultrasonography
Medical history:
(1) The urgency of the onset and the duration of the duration.
(2) Whether there is fever.
(3) Whether there is nausea and vomiting, constipation, diarrhea.
(4) How much food is consumed.
(5) Whether there is weight loss.
(6) Whether there is fatigue, lack of energy, insomnia, and excitement.
(7) Is it cold?
(8) Whether to drink alcohol or eat certain drugs.
(9) Whether there is a history of trauma.
(10) With or without hepatitis, nephritis, gastritis, diabetes, thyroid disease, and history of tuberculosis.
Diagnosis
Differential diagnosis
(1) The loss of appetite needs to be identified as follows:
(1) Identification with fear of food:
Fear is for a variety of reasons, the main reason is that the pain does not dare to eat, rather than want to eat such as day, throat disease, esophageal disease, nervous system disease and digestive system diseases.
1 oral and pharyngeal diseases: common in oral inflammation, flat body inflammation, swelling around the tonsils, pharyngitis, etc., because of the pain when swallowing, do not dare to eat.
2 esophageal diseases such as esophagitis and esophageal cancer cause swallowing pain.
3 nervous system diseases: such as pseudo-medullary palsy, swallowing and not afraid to eat.
4 intestinal ischemia syndrome: intestinal vascular perfusion caused by intestinal vascular disease, often occurs in mesenteric arteriosclerosis, mesenteric vasculitis after eating colic, usually abdominal pain after 20 minutes of eating, abdominal pain, More in the umbilical cord and abdomen. Occasionally, at the beginning, every meal must be ill, so that patients do not dare to eat pain for a duration of time, mostly for one or two hours.
5 pancreatic cancer, chronic pancreatitis: this disease can also occur abdominal pain about half an hour after a meal, the pain is mostly located in the upper abdomen, is persistent pain. Sometimes the pain is very heavy and the patient is afraid of eating. The abdominal pain is usually 1 to 2 hours.
(2) Identification with antifeeding:
Refusal refers to refusal to eat and is common in people with mental illness.
(2) The intractable loss of appetite requires attention to the following diseases:
Short-term appetite loss, often have a clearer incentives, such as fever, mental stress, mental trauma, after taking some drugs, etc., a tunnel incentives are removed, often resolutely restored. If the loss of appetite lasts for a long time, if it has been more than 2 to 3 weeks, especially those with a weight F drop should be carefully examined to find the cause of the disease. Intractable loss of appetite, accompanied by significant weight loss, in addition to anorexia nervosa. Mostly due to organic lesions.
(1) Anorexia nervosa is a disease associated with mental factors. It is intended to control the diet to reduce weight and maintain body shape. There is a lot of hunger at first, and after a long time, there is a significant anorexia because there are too few foods for a long time, and malnutrition, metabolism and endocrine disorders occur. Weight loss can reach more than 25% of the original weight. Men can have low libido, and women can have amenorrhea more often than young women can eventually develop cachexia or even death.
(2) Common people with endocrine diseases are:
1 Xi Han disease: due to massive hemorrhage during childbirth caused by vertical ischemia and necrosis caused by pituitary dysfunction. Insufficient secretion of gonadotropin, thyroid hormone deficiency such as postpartum no milk, amenorrhea, hair loss, causing hypothyroidism. Digestive symptoms such as hypotension and hypoglycemia are bloating constipation and significant loss of appetite.
2 hypothyroidism, can also occur a significant loss of appetite.
3 Adrenal gland disease: severe destruction of the adrenal gland caused by bilateral adrenal gland ginger, tuberculosis, and tumor. In addition to fatigue, pigmentation and weight loss, there are also obvious food, nausea, vomiting, abdominal pain, diarrhea.
4 diabetic ketoacidosis: diabetic patients, clinical manifestations of polydipsia, polyphagia, polyuria. However, when ketoacidosis is poisoned, there may be loss of appetite, nausea and vomiting, and severe abdominal pain.
5 patients with hyperthyroidism and hyperthyroidism, due to strong mental stimulation, severe infection, surgery and other factors, caused a large number of thyroxine into the blood. In patients with hyperthyroidism, the clinical manifestations are mainly polyphagia and weight loss. However, in the crisis, digestive symptoms such as loss of appetite, nausea, vomiting, and diarrhea may occur.
(3) Digestive diseases: common in chronic atrophic gastritis, hepatitis, cirrhosis, chronic pancreatitis, pancreatic cancer.
(4) Slowly remove infectious diseases: common in tuberculosis.
(3) The accompanying symptoms of loss of appetite help to identify the cause of the disease:
(l) With fever: In addition to infection, malignant tumors should be excluded.
(2) accompanied by jaundice: should be considered first caused by liver and biliary diseases.
(3) accompanied by abdominal pain: in addition to due to digestive system diseases, liver and gastrointestinal congestion caused by right heart failure, renal colic caused by stones, uremia, diabetic ketoacidosis can have severe abdominal pain associated with Loss of appetite.
(4) accompanied by recent weight loss: common in pancreatic cancer, hepatitis tuberculosis, and other parts of malignant tumors.
(5) accompanied by diarrhea: common in gastrointestinal inflammation, electrolyte loss due to diarrhea such as hyponatremia, hypochloremia, can also cause loss of appetite.
(6) accompanied by anemia: in addition to blood system lesions can also be seen in uremic gastrointestinal tumors.
(7) accompanied by obvious fatigue: common in hepatitis, uremia, severe anemia, severe tuberculosis, dystrophic tumor, stagnation function, hypothyroidism, renal glandular dysfunction, acute infectious diseases.
