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Palliative Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Causes of anorexia are: Disease itself, with high metabolic rateFear of vomitingPresentation of food (too much, unappetizing)ConstipationOral problems (e.g. oral candidiasis, mouth ulcers, dry mouth)Oral tumourBiochemical abnormality (e.g. hypercalcaemia, uraemia, hyponatraemia)Medications, radiotherapyDepression or anxiety
Answers
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Eating disorders such as anorexia and bulimia nervosa affect many young people of both sexes, although are commoner in females. They involve a pathological fear of weight gain, with distorted cognitions involving weight and body image. This results in severe dieting and weight-loss tactics such as diuretic or laxative abuse, purging and extreme exercise and a BMI < 17.5 kg/m2. Low body weight may cause amenorrhoea and other physical effects, such as exhaustion, dizziness, constipation and low blood pressure. More serious problems can occur, such as electrolyte imbalance and malnutrition. Other psychological illness may coexist, such as depression, anxiety, personality disorders and OCD. Management focuses on restoring nutritional balance and body weight, and psychotherapy to address the underlying and maintaining factors of the damaging behaviours. Eating disorder units can involve patients in their own care with group therapy and concentration of specialist services.
Overview of the Research
Published in Kate B. Daigle, The Clinical Guide to Fertility, Motherhood, and Eating Disorders, 2019
Many of the physical complications of anorexia are due to effects of starvation. In a woman, a major marker of this disease is amenorrhea, or the loss of her period. Primary amenorrhea occurs when a woman age 15 or older never has had her period, and secondary amenorrhea occurs in a woman who has had regular periods but loses her period for a time span of 3 months or more. The loss of menstruation prohibits egg production and shuts down the reproductive system. Hypothalamic amenorrhea, a component of secondary amenorrhea, is common in people with anorexia and occurs when the hypothalamus, which is in the center of the brain and controls reproduction, stops producing gonadotropin-releasing hormone (GnRH). This is the hormone that starts the menstrual cycle, and it can stop it if it does not sense sustainability. One of the factors of this is low body weight, which may or may not be connected to an eating disorder.3
The embodiment of childhood abuse and anorexia nervosa: A body mapping study
Published in Health Care for Women International, 2023
Jennifer S. Malecki, Paul Rhodes, Jane Ussher, Katherine Boydell
We assessed and defined anorexia using the Eating Disorder Examination Questionnaire (Fairburn & Beglin, 2008). We used a broad definition of childhood trauma that refers to children under the age of 16 years who have experienced traumatic emotional, physical, or sexual events that overwhelmed their psychological functioning, disrupting the capacity to thrive in the social environment and assessed childhood abuse using the Child Trauma Questionnaire (CTQ) Short Form (Bernstein et al., 1994). All research participants interviewed were aged between 18 and 84 years, of which 87.5% identified as heterosexual, low to middle socioeconomic status representing Anglo Australian, and the remainder identified as Italian and Middle Eastern ethnicities that were living in metropolitan or regional areas of Australia
Some Treatments Over Objection, Not Others, Are Ethically Justifiable When Managing Anorexia Nervosa
Published in The American Journal of Bioethics, 2023
While refeeding is a necessary part of Ms. Johnson’s recovery from anorexia, it will almost certainly not be sufficient. Patients with anorexia typically take months or years to recover, and recovery often requires treatment from an array of medical, nutritional, and mental health providers. Thus, it is likely that Ms. Johnson will need further multimodal treatment in order to achieve long-lasting, sustainable recovery. To this end, Ms. Johnson’s treatment team recommends residential treatment following discharge. While a time-limited intervention of nutrition delivery via feeding tube can be justified by an appeal to soft paternalism, forced treatment at a residential facility cannot be similarly justified. The time it takes for Ms. Johnson to be medically stabilized via refeeding (typically on the order of days to weeks, including monitoring for refeeding syndrome) should be sufficient to monitor any changes to her capacity status and make a final capacity assessment.
The impact of nutritional status on pancreatic cancer therapy
Published in Expert Review of Anticancer Therapy, 2022
Gabriele Capurso, Nicolò Pecorelli, Alice Burini, Giulia Orsi, Diego Palumbo, Marina Macchini, Roberto Mele, Francesco de Cobelli, Massimo Falconi, Paolo Giorgio Arcidiacono, Michele Reni
Pain is a cardinal symptom of PDAC, being the first complaint in some 25% of the patients [10]; it has a strong prognostic significance as it is secondary to neuroinvasion [13], but lack of pain control is also associated with decreased caloric intake [14] and should be treated proactively during the course of the disease. While the treatment is typically established by pain specialists, interestingly, it has been recently reported that pain is often undertreated, resulting in very frequent interference with daily activities and that being treated by a gastroenterologist is associated with less undertreatment of pain, possibly due to the relevance of digestive functions [15]. As for GOO, recent guidelines suggest treating patients with a better life expectancy and good functional status with either surgical or endoscopic ultrasound-guided gastrojejunostomy, while duodenal (enteral) stenting use should be limited to patients with a worse prognosis [16,17]. Anorexia, defined as the loss of desire to eat, can also be caused by a) gastrointestinal complaints, such as bloating, nausea, dysmotility, or constipation that require specific treatment; b) fatigue, anxiety, and depression; c) changes of smelling and taste that can be caused by therapy [18].