Exhaustion is an extreme degree of weight loss (more than 20%), in which the work of various organs and systems is disrupted. The condition is often accompanied by symptoms of nervous exhaustion, weakness, weakness. Exhaustion of the body occurs in anorexia, chronic diseases of the gastrointestinal tract, cancerous and other types of intoxication. To establish the factors that caused the disorder, ultrasound and X-ray imaging methods, a neurological examination, and laboratory tests are prescribed. To normalize body weight, adequate oral or parenteral nutrition is necessary in combination with etiotropic therapy for the cause of weight loss.
The condition is more common in younger women. The first signs of the disorder are constant dissatisfaction with your body and the desire to lose weight by any means. Girls with anorexia begin to restrict themselves in food, adhere to strict diets, against which they lose up to 10-15% of their body weight, and cause vomiting after eating. Rapid exhaustion occurs, the appearance and quality of the body changes - the skin becomes dry and flabby, gathers in folds, hair falls out, nails begin to exfoliate. There is constant weakness and fatigue. At the same time, the patient continues to consider herself fat and follows a diet.
The progressive depletion of the body causes severe changes in all internal organs, which indicates the transition to the cachectic stage of anorexia. Weight loss is 20-30% or more, a complete refusal to eat is possible. Subcutaneous fat disappears, all ribs, pelvic bones, and collarbones are well contoured. Due to severe metabolic disorders, extensive edema is formed, amenorrhea sets in, and sexual desire disappears. When the first signs of anorexia and exhaustion appear, it is important for the patient to provide qualified medical assistance.
The narrowing of the lumen of the esophagus and the lack of movement of food into the stomach are common causes of malnutrition, which are caused by post-traumatic strictures of the organ, space-occupying formations. At the initial stage, food partially enters the stomach, so the general condition remains satisfactory, weight loss is no more than 5%. As the stenosis of the esophagus progresses, the exhaustion of the body worsens, each attempt to eat ends in vomiting, so patients deliberately refuse to eat. Sharp weight loss is accompanied by swelling and an increase in the size of the abdomen due to emerging ascites.
Signs of exhaustion occur against the background of dyspeptic manifestations: vomiting several times a day, heaviness in the abdomen after eating, prolonged diarrhea. Symptoms are due to malabsorption syndrome, in addition, patients reduce portions of food, as a result of which the diet is depleted of proteins and vitamins. There is rapid weight loss, sagging and hyperpigmentation of the skin. A lack of vitamins causes menstrual dysfunction in women and a decrease in potency in men, diffuse alopecia and fragility of the nail plates are characteristic. Exhaustion is often caused by reasons such as:
With the accumulation of toxic compounds and waste products of bacteria in the blood, typical symptoms of exhaustion appear: progressive weight loss against the background of reduced appetite, deterioration of the skin and hair, and sexual dysfunction. The clinical picture often develops with prolonged subfebrile body temperature, profuse sweating and a sharp pallor of the skin are characteristic. The lability of emotional reactions quickly manifests itself, neurotic states are formed. Common causes of depletion of the body:
Exhaustion of the body is possible with neoplasms of any localization, which is associated with cancer intoxication, increased catabolism (processes of the breakdown of substances). Patients lose more than 20% of their body weight in a short time, which is accompanied by a complete disability, a characteristic appearance: fatty tissue is practically absent, skin is flabby, pale with a yellowish tint, sparse hair, exfoliating nails. With neoplasms of the gastrointestinal tract, the development of cancer cachexia occurs faster, due to mechanical obstacles to the movement of food and malabsorption of nutrients.
The clinical picture is dominated by weight loss of 2-6 kg per month, combined with general exhaustion of the body. Weight loss occurs evenly, body proportions are preserved. The skin becomes thinner and becomes very dry (like tissue paper), sweating decreases up to anhidrosis, hair falls out in the armpits and on the pubis. Dystrophic processes in the internal organs are manifested by hypotension, frequent constipation, amenorrhea. Similar symptoms are observed in postpartum emaciation due to Sheehan's syndrome.
Progressive weight loss occurs in the 3rd stage of heart failure. The causes of exhaustion are dystrophic changes in the myocardium and all muscle tissue, concomitant damage to the mucous membrane of the small intestine. At the initial stages, the weight does not change, which is due to severe edema and ascites, then there is a weight loss of more than 15% of the baseline. Weakness and adynamia increase, sometimes patients cannot even get out of bed. The typical appearance of the patient includes a thin face and upper body, a large abdomen with tight skin due to ascites, swelling of the legs.
Most often, wasting occurs when an abnormal amyloid protein is deposited in the gastrointestinal tract. In this case, the process of digestion and absorption of food is disrupted, since the cells of the small intestine do not perform their function. Patients with amyloidosis report significant weight loss associated with persistent diarrhea and loss of appetite. When the liver is involved in the process, the appearance of dull pains on the right in the hypochondrium after eating, vomiting with bile is characteristic. Exhaustion can be complicated by amyloidosis of the kidneys, which is accompanied by a pronounced loss of proteins.
The main reasons for a sharp weight loss and an emaciated appearance are the addition of secondary bacterial and viral infections. Weight loss of AIDS patients reaches 25% or more of the initial values, the skin looks pale with a waxy tint. Depletion is aggravated in the presence of purulent foci in the body, chronic diarrhea. Decreased libido, no menstrual function in women. Beginning HIV encephalopathy is manifested by signs of nervous exhaustion - irritability, apathy, then cognitive abilities worsen (memory, attention, understanding of what is happening).
To clarify the cause of malnutrition, a consultation with a therapist is usually required, who is responsible for the initial examination and excludes the most typical factors that cause weight loss. A comprehensive study of the state of internal organs, an assessment of neurological and mental reactions is necessary. The following methods have the greatest diagnostic value:
If the symptoms of exhaustion of the body are accompanied by "small signs" of oncological pathology (fatigue, lethargy, general malaise, anemia), it is necessary to examine the blood for tumor markers, conduct additional instrumental procedures - CT of the abdomen and chest, body scintigraphy. All patients are screened for HIV infection. When exhaustion is combined with a dysmorphomanic state, a psychiatric consultation is required to rule out a neurotic or psychotic cause of the disorder.
The onset of wasting symptoms is usually caused by serious causes that cannot be eliminated by self-treatment. In most cases, emergency medical care is required to prevent critical irreversible changes in internal organs. If the symptoms occur against the background of anorexia nervosa, and the patient does not consider himself ill, relatives and close friends can arrange a consultation with a specialist or take the person to a specialized clinic.
malnourished patients require nutritional supplementation
The main goal of treatment is to replenish nutritional needs. With a mild form of depletion of the body, the calorie content of the diet is gradually increased, the diet should contain a large amount of protein, complex carbohydrates and vitamins. In severe situations, tube feeding or parenteral administration of special solutions of amino acids and fat emulsions is indicated. Anorexia requires individual and group psychotherapy. For etiotropic therapy of conditions that cause exhaustion, the drug treatment regimen includes:
If a malignant neoplasm is identified as the cause of depletion, radical interventions are needed to remove the neoplasia along with the affected tissue and lymph nodes. In stage 1-2 cancer, organ-preserving operations are the method of choice. In advanced cases, advanced techniques are used. For the treatment of depletion of the body, which is caused by a violation of the patency of the esophagus, stenting of the narrowed area is performed. If necessary, esophagoplasty is performed with gastric or intestinal transplants.