The centers of hunger and saturation are in the hypothalamus. There are many ways in which diseases of the digestive organs to these centers are sent pathological impulses that cause a decrease in appetite. The saturation center is stimulated by the stretching of the stomach and the upper part of the small intestine. From chemoreceptors of the intestine to the center of appetite comes information about the availability and assimilation of nutrients. The centers of hunger and saturation are also affected by circulating factors (hormones, glucose, etc.), the content of which, in turn, depends on the state of the intestine. To the hypothalamus from the higher centers there are signals caused by pains or emotional reactions that occur in diseases of the digestive tract.
The child's appetite is subject to considerable fluctuations. It is briefly reduced, which can often be associated with poor nutrition, the quality of food culinary processing, monotony of diet, lack of drinking 8 hot season and other factors. Long-term disturbances of appetite, its reduction down to absence (anorexia) are associated with various pathologies and intoxication, diseases of the digestive system, nervous system, etc.
In the newborn period, all pathological conditions that complicate the act of sucking lead to rhinitis, congenital defects in the development of the posterior nasal apertures (stenosis, atresia), organic lesions of the central nervous system, suppression of the sucking reflex, for example, with prematurity or birth trauma, mucosal diseases lead to a decrease in appetite. Mouth,
In infants, a decrease in appetite occurs in the case of a violation of the principles of feeding (overfeed, high-calorie with excess fat, one-sided high-protein nutrition), forced feeding, distraction of the child's attention during meals with various stories, games, pictures. Sometimes there is a selective lack of appetite only in relation to solid foods.
One of the common reasons for the decrease in appetite in pre-school and school-age children is a violation of the diet, the intake of sweets (ice cream, cookies, sweets) in between the main meals.
Decreased appetite is observed in almost all acute and chronic diseases, anemia, certain endocrine diseases (hypothyroidism, addison's disease), liver diseases ( cirrhosis of the liver ), severe cardiovascular pathology, poisoning, hypervitaminosis D, idiopathic hypercalcemia, the use of certain medications (sulfanilamide preparations , antibiotics, salicylates). Loss of appetite is observed with intoxication and acidotic shift.
A persistent decline in appetite is typical for patients with chronic eating disorders, Gilovitaminosis C and B. Active eating, perverted, selective appetite is a characteristic feature of children suffering from a neuropathic form of congenital dystrophy. Selective anorexia occurs with celiac disease (rejection of products from wheat, rye flour, barley), enzymopathy - disaccharidase insufficiency (rejection of a carbohydrate), exudative enteropathy (rejection of whole milk), liver and biliary tract diseases (rejection of oily food), with food allergies to products containing an allergen. With constant disregard of the age principles of nutrition by parents or carers of the child, psychogenic anorexia develops, often accompanied by vomiting during meals. This can be a manifestation of the protective reaction of the organism in cases of forced feeding.
School-age children may experience neurogenic anorexia in combination with skin thinning and amenorrhoea due to growth characteristics, neuroendocrine restructuring, and environmental factors. Nervous (psychic, hysterical) anorexia is most often observed in pre- and puberty girls and young women. Patients begin to limit themselves to eating due to pathological discontent with their appearance, size and body weight.
There are 3 stages of the disease:
- in the first stage, lasting months, and sometimes even years, there are initial neurotic and psychopathic symptoms, an inadequate assessment of their appearance;
- in the 2nd stage there is an unreasonable fear of eating;
- in 3 stages there is a detailed clinical picture of fasting with the corresponding symptomatology.
For patients, a characteristically negative, and sometimes literally hateful attitude towards food, especially carbohydrate food. They not only sharply limit themselves in food, but also artificially induce vomiting, and abuse laxatives. Many of them are intensely engaged in physical exercises, try to do everything standing up, limit the time of sleep, in a supine position take forced postures (to increase energy consumption).
Prolonged restriction in food up to almost complete starvation leads to depletion of patients and severe malnutrition. In a period of emotional stress, some patients eat a lot (boll), and after a meal artificially cause vomiting. In severe cases, depletion reaches the degree of cachexia.
Often this is a rather severe mental illness. In connection with the polymorphic clinic, this pathology is of interest, both for psychiatrists and for internists.
Anorexia refers to very frequent symptoms that are common to a variety of diseases not only the digestive tract. However, in refusing food the doctor, first of all, thinks about the diseases of the gastrointestinal system.