Anorexia

Introduction Food intake is regulated by two central regions of the hypothalamus, the ventral lateral "feeding center" and the ventral medial "satisfaction center", which produces a feeling of fullness after eating, inhibiting the activity of the former, and contracting the brain gut peptide CCK appears to have a satiety effect and may be involved in the regulation of feeding behavior and lack of appetite. It can be caused by diseases of the digestive system, or by other system diseases other than the digestive system or diet disorders.

Cause

1, digestive diseases: such as acute hepatitis, loss of appetite can occur before the onset of jaundice, appetite deficiency may be a prominent symptom. Acute and chronic gastritis, especially chronic atrophic gastritis, can cause severe loss of appetite, intestinal diseases such as intestinal tuberculosis, enteric typhoid, chronic dysentery and colon cancer can cause loss of appetite.

2, parenteral disease: chronic pain in any part can cause loss of appetite. Fever caused by various causes, low blood sodium, low blood chlorine and acidosis, digestive system congestion caused by right heart failure can cause loss of appetite. Anorexia can be the main symptom of uremia, respiratory failure and various endocrine diseases, such as hypothyroidism, adrenal insufficiency, and hypopituitarism. In addition, some drugs such as antihypertensive drugs, diuretics, ephedra, aspirin, tetracycline, chloramphenicol and anesthetic analgesics can cause anorexia.

3, neuropsychiatric factors: depression often accompanied by lack of appetite, emotional annoyance, boredom or unpleasant scenes, vision, smell, taste, etc. can affect appetite, mental patients can refuse to eat.

an examination

Related inspection

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1. History: The urgency, duration and progress of the loss of appetite, whether there are other accompanying manifestations such as fever, nausea, vomiting, difficulty in swallowing, diarrhea, constipation, abdominal pain, history of taking drugs and history of drinking, Whether there is no history of tuberculosis, gastritis, hepatitis, kidney disease, diabetes, whether there is a history of trauma and a clear cause, whether the weight has changed.

2, physical examination: pay attention to nutritional status and mental state. Whether the skin has yellow staining, dehydration, edema, hyperpigmentation, whether there is heart enlargement, whether there is liver congestion, whether the liver jugular vein reflux sign is positive; whether there is cirrhosis, splenomegaly and ascites sign, whether there is tenderness or rebound Pain and lumps.

Differential diagnosis

It should be differentiated from the fear of eating, the latter is not for food for various reasons, such as oral diseases causing pain during chewing and swallowing, esophageal diseases cause difficulty in swallowing or swallowing pain. Pancreatitis, cholecystitis, and intestinal ischemia syndrome are manifested as postprandial abdominal pain and fear of eating.

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