Cachexia - what is it? Cachexia, in other words, depletion of the body is a complex process, characterized by significant loss of body weight and general weakness, as well as a change in the psyche. At the same time, fat and carbohydrate reserves are drastically depleted, protein synthesis is reduced with a simultaneous increase in its catabolism (destruction). Also, cachexia can occur with cancer.
Primary and secondary depletion
There are two forms of cachexia disease - primary and secondary. Primary depletion is also called pituitary, and secondary is symptomatic.
● Primary or exogenous cachexia occurs due to insufficient intake of nutrients in the body, and also as a result of the following disorders: brain injury, tumor or systemic damage to the pituitary gland, autoimmune pituitary gland, prolonged stress, hemorrhage (hemorrhage with thinning of blood vessels), anorexia, embolism ( the ingress of foreign particles into the blood stream, causing blockage of blood vessels), a chronic specific infection.
● Secondary or endogenous cachexia is the result of diseases and is caused by factors such as hypoinsulinism (insulin deficiency), increased glucagon synthesis, malabsorption (malabsorption of nutrients), glucocorticoid deficiency, growth of neoplasms, excess somatostatin.
Causes of occurrence
The disease cachexia occurs as a result of a number of reasons and factors:
1. Prolonged malnutrition and starvation.
2. Diseases of the gastrointestinal tract, in particular the esophagus, as well as celiac disease, enterocolitis.
3. Prolonged intoxication with brucellosis, tuberculosis and other chronic infectious diseases and suppuration processes.
4. Psychogenic anorexia.
5. Thyroid disease, adrenal insufficiency.
6. Endocrine diseases associated with metabolic disorders.
7. Heart failure.
8. Malignant tumors.
9. Hypotrophy in children.
What are the symptoms of cachexia? What are these manifestations?
Symptomatology
There are a number of symptoms that characterize cachexia. What this disease does with our body:
1. Abrupt weight loss of up to 50% of body weight, and in severe cases more than 50%.
2. Dehydration.
3. Muscle weakness.
4. Disability.
5. Sleep disturbances.
6. An increase in infection damage.
7. Lowering blood pressure (blood pressure).
8. Pallor and sagging skin.
9. Possible vitamin deficiency and tooth loss.
10. Trophic changes in hair and nails.
11. The development of stomatitis.
12. The occurrence of constipation due to impaired intestinal motility.
13. Low blood levels of protein, albumin, iron, B12.
14. Women may experience amenorrhea (cessation of menstruation).
15. Mental disorders.
Cachexia and the psyche
I would like to dwell on mental disorders with cachexia. They can manifest themselves in irritability, depression, and tearfulness, which smoothly flow into apathy, a complete breakdown. With an exacerbation of the disease that caused cachexia, amentia / amenitic syndrome
(confusion characterized by inability to navigate, chaotic movements and distraction, and incoherent thinking and speech) or delirium (insanity in which a person is in a constant state of anxiety and excitement) can be observed , sees hallucinations), pseudo-paralysis.
Oncology cachexia
Cancer cachexia is a syndrome in which the mass of skeletal muscles and adipose tissue continuously decreases with the development of tumor formations, regardless of food intake. Depletion is especially pronounced in those patients who have cancer of the digestive tract or lung. Such people can lose as much as 80% of body weight, which will lead to immobility.
Cancer as a cause of cachexia
Cachexia in cancer is possible. The cause of cachexia may be the presence of a tumor. Due to the neoplasm, the metabolism becomes atypical, adapting to it. A tumor needs substrates that can ensure its growth and development. It is no secret that cancer cachexia has a toxic effect on healthy organs and tissues, changing their structure and causing disruptions in work.
When a large amount of lactic acid is formed in the tumor, the liver is damaged. In order to normalize the concentration of lactic acid, the body begins to use blood sugar and often can not make up for losses.
With cancer cachexia observed:
- catastrophic weight loss and weakness;
- violation of the processes of self-regulation;
- reduction in plasma cholesterol;
- the development of infections due to impaired cellular and humoral immunities;
- dysphagia (difficulty swallowing);
- vomiting, diarrhea;
- increased energy requirements;
- antidiuresis and, as a result, hyponatremia;
- hypercalcemia;
- swelling;
- increase in blood glucocorticoids;
- In some cases, delirium and even coma.
The consequences of cancer cachexia
Oncological cachexia is very dangerous. An increase in glucocorticoids in the blood activates the processes of gluconeogenesis (glucose synthesis) in the liver and muscle tissue, increases the breakdown of proteins and fats. Hypoglycemia (low blood glucose) develops due to cancer cells absorbing glucose. Against this background (to which stresses can be added), endocrine glands actively produce hormones, an excessive amount of which leads to intoxication of the body and hemic hypoxia (the difference in the arterial-venous oxygen gradient decreases). Homeostatic deviations occur. All this can be fatal.
Cachexia treatment
Most of the treatment of cachexia patients is carried out in hospitals or dispensaries. The main treatment includes therapy to get rid of neoplasms. Nutrition is also being restored, which is achieved by enriching the body with vitamins, trace elements, fats and proteins. Easily digestible products can be used for this. Use such drugs: multivitamin for the treatment of hypovitaminosis, enzyme to improve digestion. Food is administered in two ways: enteral (when it enters the gastrointestinal tract) and parenteral (food passes by the gastrointestinal tract). The parenteral method is used to remove a patient from a serious condition (coma) with cancers and treatment after them, severe exhaustion, severe infections, and swallowing disorders. In this case, glucose, vitamins, amino acid mixtures, electrolytes, protein hydrolysates are administered (administered parenterally). Also, appetite-enhancing agents are used in practice. If the patient suffers from violations of the digestion of food and its absorption, polyenzyme preparations are used in the treatment (Pancreatin drug, Festal drug).
To prevent vomiting, the agent Delta-9-tetrahydrocannabinol is prescribed. It is effective after chemotherapy. The cannabinoids contained in this preparation stimulate appetite and, consequently, weight gain. Weight loss can be stopped with fish oil, which is why it is also part of the treatment program for a disease such as cachexia.
Medication treatment.
To eliminate cachexia, the following drugs are used:
1) "Carboxylase" - helps to normalize weight, relieves pain and supports the functioning of body systems. Side effects are allergies. It can not be used if the body is susceptible to at least one component.
2) "Megace" or "Megestrol acetate" - stimulates the increase in muscle mass and fat. It can not be used if there is sensitivity to the components of the drug, persons under 18 years of age, during pregnancy and breastfeeding.
In the presence of infectious diseases, antibiotic therapy is included in the treatment. If necessary, anabolic hormones are administered. In cases of psychogenic disorders, a psychiatrist treats.
We hope that we answered your question "Cachexia - what it is, how to determine and how to fight."