CACHEXIA

KAHEXSIYA - the extreme degree of exhaustion of the body, characterized by a sharp thinning, general weakness, a decrease in the activity of physiological processes, changes in the psyche. The causes of cachexia can be fasting or prolonged malnutrition (see Alimentary dystrophy), esophagus lesions that impede food intake into the stomach, and diseases of the gastrointestinal tract that occur with syndromes of impaired digestion and food intake (chronic enterocolitis, condition after gastrectomy, gastrectomy ), Psychogenic anorexia , chronic intoxication with chronic infectious diseases (tuberculosis, brucellosis, etc.) and purulent processes (abscesses, suppurative bronchiectasis, osteomyelitis), amyloidosis , depleting diffuse connective tissue diseases (especially nodular polyarteritis), severe heart failure , malignant tumors (Cancer cachexia), metabolic disturbances in endocrine diseases, in particular adrenal insufficiency, thyroid diseases.

Clinically, cachexia is manifested by pronounced weakness, loss of ability to work, a sharp weight loss, which is often combined with signs of dehydration, although in some cases protein-free edema of subcutaneous fat and accumulation of transudate in various body cavities are observed. In severe cases, weight loss can reach 50% or more. The skin of the patients becomes pale or earthy-gray, flabby, wrinkled; Subcutaneous fat decreases or disappears, often there are signs of vitamin deficiency. Trophic changes in hair and nails are noted. Develops stomatitis, teeth often drop out; Impaired peristalsis of the intestine, often marked by persistent constipation. The sexual function decreases, and amenorrhea occurs in women. The volume of circulating blood decreases, the blood pressure is usually reduced.

The course and outcome of cachexia depends on the nature of the disease that caused it. The development of cachexia in malignant tumors usually indicates a late stage of the disease with an unfavorable prognosis for life. With cachexia of another etiology, it is possible to improve the condition of patients with rationally administered therapy for the underlying disease.

Treatment is directed primarily to the underlying disease, but necessarily includes measures to restore the nutrition of patients, as well as careful general care for them. The diet is enriched with protein and fats, vitamins, whenever possible, digestible products are used. With symptoms of impaired digestion and absorption of food, polyenzymes (fistal, pancreatin , etc.) are prescribed . To remove patients with cachexia from a severe condition, parenterally introduce solutions of glucose, electrolytes, vitamins, protein hydrolysates, amino acid mixtures. Anbaric hormones are used for indications.