What is Anorexia?
Written by Gary Presant, MD
Monday, 05 October 2009
Most people have experienced a temporary loss of appetite at some time. This is rarely a worrisome symptom unless it lasts for more than a day or two.
What is going on in the body?
A loss of appetite can be quite concerning when it fails to go away. It can be a sign of a serious underlying condition, such as depression or cancer. It also commonly occurs during a sudden illness, such as an infection. When a loss of appetite continues for a long time, a person is at risk for malnutrition.
What are the causes and risks of the condition?
There are many causes of a loss of appetite that continues for more than a few days, including:
- infections, such as pneumonia, hepatitis, HIV, influenza, or a kidney infection called pyelonephritis
- serious liver, kidney or heart disease. For instance, chronic renal failure, cirrhosis, or congestive heart failure can cause a loss of appetite.
- cancer of any kind, such as colon cancer, stomach cancer, or a blood cancer called leukemia
- blockage in the bowels, known as intestinal obstruction
- inflammation in the bowels or gut, such as occurs with pancreatitis, an inflammation in the pancreas, irritable bowel syndrome, or appendicitis
- endocrine problems, such as diabetes mellitus, or a condition that causes low thyroid hormone levels called hypothyroidism
- autoimmune disorders, conditions in which a person's immune system attacks his or her own body. Examples include rheumatoid arthritis and scleroderma.
- psychiatric conditions, such as depression, schizophrenia, or an eating disorder called anorexia nervosa
- medications or drugs, such as alcohol, narcotics, antibiotics, chemotherapy medications used to treat cancer, and a diabetes medication called metformin
- dementia, such as Alzheimer's disease, a condition that causes decreased memory and a decline in other brain functions
Many other causes are also possible. Sometimes, no cause can be found.
What are the treatments for the condition?
There are medications available to try to stimulate appetite in people with an incurable cause for their loss of appetite. These medications include megestrol and dronabinol. If nausea is the main reason for the loss of appetite, medications to treat nausea, such as ondansetron or promethazine, can be given. For other people, nutrition supplements may be needed, such as high-calorie nutrition shakes or even artificial feeding through a gastrostomy tube. These measures are sometimes needed in people with dementia.
Other treatment is directed at the underlying cause. For instance, people with appendicitis usually need surgery. Those with infections often need antibiotics. Those with low thyroid hormone levels need hormone replacement pills. Those with cancer may need surgery, chemotherapy, or radiation therapy.
What are the side effects of the treatments?
Side effects depend on the treatments used. For instance, medications used to treat nausea may cause drowsiness. Antibiotics may cause allergic reactions or stomach upset. Surgery carries a risk of infection and bleeding.
What happens after treatment for the condition?
This depends on the cause. For instance, pregnant women often get their appetite back after several weeks and need no further treatment. Those with diabetes need lifelong monitoring and treatment. Those with cancer may die if treatment doesn't cure the cancer.
How is the condition monitored?
The person's weight and nutritional status may be monitored. Affected people can report any change in appetite or response from treatment to the healthcare provider. Further monitoring is related to the underlying condition. For instance, those with low thyroid hormone levels who are taking hormone replacement pills may need thyroid function tests in the future to make sure the right dose is being given.
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