Protein-free edema of the feet
Today much is said about excess weight and problemswith the health that he provokes, but about such a serious disease as alimetar dystrophy is almost forgotten. Many people think that it is typical for the countries of Africa or the belligerent powers. Although in fact, in developed countries and in our country, this diagnosis is not a rare thing, considering that not only the ballet dancers and models, but almost a third of the population, are engaged in the struggle for a harmonious figure. A deliberate starvation, typical for patients with anorexia nervosa, an unbalanced diet, promoted by fashionable diets, is the way to alimentary dystrophy. This diagnosis is made for patients who have a body mass deficit of 20 or more percent of the norm, or a body mass index of less than 16.
As a result of a serious restructuring of all functionsorganism, vital organs and systems suffer, and as a consequence, hair begins to drop out, bleeding gums, fingernails crack, skin dry, other signs of multivitamin deficiency appear, women lose monthly (amenorrhea). The doctor can understand that before him is a patient suffering from anorexia under conditions when:
- the patient does not eat more than 2-3 times a day;
- the amount of food per 1 intake does not exceed 100-150 g;
- often "fast" carbohydrates are used for food (chocolate, sweets, ice cream);
- The diet excludes such vital products as meat, cereals, dairy and other foods;
- skin dry, sometimes blushing on the hands and feet in the form of "gloves" and "socks";
- nails thinned, striated, brittle;
- hair dull, brittle;
- tongue of "crimson" color, smooth, "polished", with smoothed papillae, teeth are visible on its lateral surface;
- changes in the work of the cardiovascular system: hypotension, bradycardia (with the slightest physical exertion becomes a tachycardia);
- changes in the work of the genitourinary system, for example, frequent urination.
Alimentary dystrophy has several stages of development. First - euphoric. The man feels great - noticeably"Go" the volume, he finds a beautiful figure, he has a fine mood, good performance, and the feeling of hunger does not bother him. But he does not understand that it is already enough to lose weight and continues to severely restrict the diet. As a result, astenobulimic a state when, against a background of not very good state of health, there is lethargy, weakness, a person is constantly very hungry, but still limits himself to eating. Then comes asthenoanorexic state - it can be called critical, becausethat a person can no longer eat, since all organs and systems are used to working in the "economy" mode and reduced. For example, menstruation in women disappears because the ovaries are cut 5 times. At this stage, it is necessary to stop the patient, otherwise he will die.
Alimentary dystrophy occurs as a result offorced (intentional) starvation or prolonged malnutrition and is characterized by a general exhaustion, a disorder of all kinds of metabolism, dystrophy of tissues and organs with a violation of their functions. This is a very serious disease. As practice shows, without a qualified treatment the life expectancy of the patient from the moment of diagnosis "alimentary dystrophy" is no more than 3-5 years: patients die most often from cardiovascular insufficiency or an infected infection. With the diagnosis of "alimentary dystrophy," the first thing that needs to be done is to contact a specialist who will most likely send the patient to a hospital.
Deficiency of body weight is quite common anda serious problem for residents of not only the countries of the third world, but also economically sound states, since the cause of dystrophy - malnutrition can be both intentional and forced. Intentionally, a person refuses to eat, for example, because he wants to be a model, an artist or achieving certain proportions of the body for him - the purpose of life. They often bring themselves to the exhaustion of the daughter of full mothers, not wanting to become the same. They have anorexia (refusal of food). Dystrophy also develops sometimes in those who have been fat and thin. They constantly want to eat, eat a lot, but after a meal cause a vomiting, so as not to recover.
Forced starvation is a situation where a person is very hungry, but can not, for example, after an operation on the esophagus or after a maxillofacial trauma.
Of course, this disease occurs in socially unprotected and low-income strata of the population (in children and adolescents from disadvantaged families, etc.).
For the development of the disease, not onlyabsolute, but also relative (disproportionate to physical exercise) decrease in calorie content of food, qualitative changes in the diet, especially protein deficiencies (mainly animals), fats, lack of essential amino acids, fatty acids and vitamins (especially fat-soluble).
With prolonged nutritional deficiencies,hypoproteinemia (abnormally low protein content in the blood), dystrophic changes in various organs and tissues, the function of many organs is disrupted, and polyendocrine insufficiency occurs. Dystrophic changes in the wall of the digestive tract and digestive glands are accompanied by progressive impairments of their functions and further exacerbate changes in metabolism in the body.
There are 3 stages of alimentary dystrophy.
Step I characterized by a decrease in diet, pollakiuria(frequent urination 15-20 times a day or more, which is accompanied by pain and very strong urge), increased appetite, thirst, desire for increased consumption of table salt. The general condition of patients does not suffer dramatically.
In II stage along with a clear weight loss, the overallthe condition of patients, there is muscle weakness, lost ability to work, hypoproteinemic edema appears on the legs, the body temperature decreases moderately. There is an increased appetite and thirst, poly- and pollakiuria, initial dystrophic changes in various organs, changes in the psyche.
For Stage III cachexia (deep stateexhaustion and physical weakness of the body), complete disappearance of subcutaneous fat, muscle atrophy, severe weakness - to complete inability to perform independent movements, apathy, marked changes in the psyche, paresthesia, polyhypovitaminosis, signs of cardiac, liver failure, anemia, painful constipation, often bedsores. Then, pronounced hypothermia develops (body temperature decreases in some cases to 30 ° C), hypotension, acidosis (a condition characterized by an increased acid content in fluids and body tissues). If you do not take emergency measures, the disease progresses until the development of a hungry coma. Without medical assistance in the III stage of alimentary dystrophy the patient either slowly dies or perishes during the day due to the inability of the body to resist infectious disease (pneumonia, tuberculosis, intestinal infections, etc.). In addition, there is a risk of sudden death at the time of even a small physical strain.
The reasons for this outcome are not only thatthe body does not receive (or insufficiently digest) nutrients, because the person limits their use. They are caused by changes that have occurred in the body - tumor, cicatricial narrowing of the esophagus, pylorus, syndromes of insufficiency of digestion, absorption.
Since deficiency of body weight occurs atvarious diseases, including cancer, a multifaceted examination and carefully collected history (a conversation with a description of the history of the disease) is required.
If the diagnosis of "alimentary dystrophy" is established,it is impossible to restore body weight and not to harm the body. Only a doctor can make a special diet that provides the necessary weight gain, but does not overload the weakened digestive system of the patient. In addition, he will adjust the patient's eating behavior, prescribe him a drug therapy, and, if necessary, parenteral nutrition. Only complex treatment, tailored by a specialist (taking into account the specificity of the development of alimentary dystrophy in a particular patient and taking into account the diseases developing on its background) will yield the necessary results. Remember, attempts at self-treatment only delay the beginning of effective assistance and exacerbate an already grave condition.
In the early days, the observance of the fullphysical and mental rest, complete, rich in vitamins and protein nutrition with a gradual expansion of the diet. Simultaneously - intravenous injection of plasma, protein hydrolysates, vitamins.
With alimentary dystrophy caused by a violationpatency of the upper parts of the digestive tract, first of all - elimination of the cause (tumor or cicatricial stenosis of the esophagus, achalasia of the cardia) or palliative surgery (gastrostomy, etc.). In parallel, symptomatic therapy is carried out: the fight against acidosis, cardiovascular insufficiency. To do this, diuretics are prescribed (with pronounced edema), anabolic steroid hormones.
When hungry coma requires intravenous administrationsolution of glucose, blood substitutes, plasma, protein hydrolysates, with convulsions - a solution of calcium chloride. In this case, the patient must always be warmed. To remove from the coma, the patient is shown hot sweet tea, then frequent fractional feeding of the patient with the most easily digestible food.
Since malnutrition isfunction, then treatment should be comprehensive. To treat a person should not only dieticians, but also psychologists, and psychotherapists, physiotherapists. The patient needs therapeutic exercise, so that he is not afraid to recover when he starts eating right.
The body is so organized that it can recover. During the blockade people almost completely starved for four months and partially - the next almost 2 years. As a result, according to different evidence, in 1942, alimentary dystrophy suffered up to 90% of Leningrad residents. Many of those who managed to survive the blockade live up to 80-90 years.
The text uses the thesis of Elena Nikolaevna Lapteva "Clinico-pathogenetic forms of alimentary dystrophy and the effectiveness of differentiated therapy."
After poisoning with cask milk, there was a constant pain in the intestines - at first it lasted 3 weeks, then 2 weeks I tried to record by phone.
3.8 Reviewed on April 12, 2016 11:21
It's very nice to write a huge thanks to Evgenia Igorevna! The first doctor said that the tooth with a cyst is only for removal and the implant should be placed (c.
4.7 Reviewed on 11 April 2016 23:33
The polyclinic itself is not bad, but apparently because of the congestion and shortage of doctors, these most unpleasant moments occur with us and our children.
2.7 Reviewed on 11 April 2016 14:06
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