ALIENTARY DISTROPHY

ALIMENTARY DISTROPHY (syn: hungry disease, albuminous edema) is a disease of prolonged malnutrition, manifested by general exhaustion, swelling, disorder of all metabolic forms, dystrophy of tissues and organs with a violation of their functions.

The cause of alimentary dystrophy is prolonged malnutrition with reduced total energy value of food and protein deficiency in the diet. Usually, alimentary dystrophy is combined with vitamin deficiency. The development of the disease is facilitated by heavy physical labor, infectious diseases, emotional overstrain, hypothermia. With insufficient intake of nutrients in the body to replenish energy costs, the stores of fats and carbohydrates are gradually being consumed, the protein catabolism is increased and its synthesis is reduced because of insufficient intake of essential amino acids. With severe alimentary dystrophy, fat stores and glycogen stores in the body completely disappear, muscle atrophy occurs, dystrophic changes in the myocardium, liver, spleen, mucous membranes are revealed. The activity of most cellular enzymes decreases, the nervous and endocrine regulation of vegetative functions and metabolism is disrupted, the functional insufficiency of the cardiovascular, respiratory, digestive systems is increasing. Reduces blood sugar, cholesterol and neutral fat, increases the level of lactic acid, develops tissue acidosis . The protein content in the blood plasma decreases, the oncotic plasma pressure decreases, which leads to the development of a general edema of the tissues. Edema fluid accumulates in the subcutaneous tissue and serous cavities. However, swelling is not an obligatory sign of the disease, it is also possible a leaky form.

Clinical picture . Patients complain (especially at the beginning of the disease) at a painful feeling of hunger, thirst. Many patients are characterized by an increased intake of table salt. Gradually, general weakness grows, work capacity decreases, pains in the muscles appear, chilliness. It is characterized by a sharp depletion, the patient's skin acquires an earthy-gray color, becomes wrinkled; Muscles are atrophic. Often, symptoms of glossitis, persistent constipation or diarrhea due to lack of digestive enzymes. Often there are frequent urge to urinate, polyuria . In severe cases, urinary incontinence can occur . Edemas (in case of their appearance) are distributed in the subcutaneous tissue relatively evenly: edematous face, trunk, limbs; Liquid is often detected in the abdominal cavity (ascites) and in the pleural cavity (hydrothorax). Body temperature is usually lowered; Determined bradycardia , deafness of cardiac tones, lowering blood pressure.

As a rule, the function of the sexual glands is disrupted, amenorrhea occurs in women. Vitamin deficiency leads to the development of anemia , as well as polyneuritis, which, along with muscle atrophy, causes severe pain in the legs. Patients become irritable, aggressive, whiny, narrowing the circle of interests. In more severe cases, there is apathy, drowsiness.

There are three degrees of severity of the disease. With alimentary dystrophy of the 1st degree, weight loss is noted, other symptoms of the disease are not clearly expressed, there is no swelling, or they occur only periodically; Ability to work is reduced. With alimentary dystrophy of grade II, severe depletion is observed, fatty tissue disappears, all symptoms of the disease are pronounced, often there are stable swelling. Alimentary dystrophy of the third degree is characterized by a severe condition of patients: they are drastically depleted (weight loss of the body can reach 40-50%), apathetic; The functional insufficiency of all life support systems is increasing, coma and death may occur. Alimentary dystrophy is often complicated by bronchitis, pneumonia, tuberculosis, and gastrointestinal infections.

Treatment . In severe alimentary dystrophy patients are hospitalized. It is necessary to keep patients warm, skin care, oral hygiene. Food should be fractional, small portions using easily assimilable products. In severe cases (when hungry coma develops), parenteral administration of amino acid mixtures, protein hydrolysates, glucose, electrolytes, and vitamins is shown. Increasing the energy value of food and expanding the range of foods should be carried out gradually against the background of the introduction of polyenzymatic drugs (panzinorma, festala, etc.).

The prognosis depends on the severity of the disease. With timely and correct treatment of alimentary dystrophy of the 1st degree. The prognosis is favorable. In severe cases, especially with the development of coma and the presence of concomitant diseases, the prognosis worsens.