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Loss Of Appetite

Loss Of Appetite

Alternate Names

  • anorexia
  • decreased appetite

Definition

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.

Risks

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
  • pregnancy
  • 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.

Prevention

What can be done to prevent the condition?

Prevention is related to the cause. For instance, avoiding drugs known to cause a loss of appetite can prevent cases due to drugs. Proper control of diabetes can prevent cases due to this cause. Many cases cannot be prevented.

Diagnosed

How is the condition diagnosed?

In some cases, the diagnosis is obvious from the history and physical exam. In other cases, further tests will be needed, depending on the suspected cause. For instance, blood tests can help diagnose diabetes, hormone imbalances, and liver disease.
Urine tests can help diagnose kidney infections or pregnancy. X-ray tests, such as a chest x-ray to look for pneumonia or lung cancer, may be needed in some cases. Other tests are also possible in certain cases.

Long Term Effects

What are the long-term effects of the condition?

Malnutrition, which is a lack of necessary food and nutrients in the body, is a concern if a loss of appetite lasts for more than a few weeks. Other long-term effects are related to the cause. For instance, diabetes can cause damage to many different organs in the body, including the kidneys, eyes, and nerves. Cancer can cause death. Infections that can be treated with antibiotics often go away and have no long-term effects.

Other Risks

What are the risks to others?

A loss of appetite is not contagious and poses no risk to others. However, the cause of a loss of appetite, such as an infection like pneumonia, may be contagious.

Treatments

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 (i.e., Megace) and dronabinol (i.e., Marinol). If nausea is the main reason for the loss of appetite, medications to treat nausea, such as promethazine (i.e., Phenergan), prochlorperazine (i.e., Compazine) or ondansetron (i.e., Zofran), can be given.
For other individuals, 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. Infections are generally treated with antibiotics. Those with low thyroid hormone levels need hormone replacement pills. Cancer is most often treated with surgery, chemotherapy, or radiation therapy.

Side Effects

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 can be complicated by infection, bleeding, or an allergic reaction to the anesthetic.

After Treatment

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 fails to cure the cancer.

Monitor

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 professional. Further monitoring is related to the underlying condition. For instance, those with low thyroid hormone levels who are taking hormone replacement medication need thyroid function tests periodically to make sure the right dose is being given.

Sources

Harrison's Principle's of Internal Medicine, 1998, Fauci et al.

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