Malnutrition (Emaciation)

Japanese: 栄養失調（るいそう） - えいようしっちょう（るいそう）（英語表記）Malnutrition (Emaciation)
Malnutrition (Emaciation)

What is the disease?

Generally, emaciation is diagnosed when a person's weight is 20% or more lower than ideal weight, but losing more than 10% of one's original weight within the past six months can also be a clinical problem.

What is the cause?

There are various causes of wasting. They can be broadly divided into 1) reduced food intake, 2) impaired digestion and absorption, 3) impaired nutrient utilization, and 4) metabolic disorders. Increased ( Public health ) The main reasons for this include the increase in heat consumption due to the

In the first category, there are endocrine disorders such as Addison's disease and Sheehan's syndrome, anorexia nervosa, depression, Schizophrenia ( Togo City Council ) Mental illnesses such as these, brain tumors, malignant tumors and debilitating diseases (such as chronic inflammatory diseases), and even Oral cavity ( Airport ) Examples include loss of appetite due to gastrointestinal diseases, including

② is a disease accompanied by chronic diarrhea, digestive disorders Ulcers ( Canker ) These include chronic pancreatitis, pancreatic tumors (WDHA syndrome and Zollinger-Ellison syndrome), protein-losing enteropathy, malabsorption syndrome, and parasites.

Also, ③ is diabetes, ④ is Hyperthyroidism ( Factory inspection report ) or Pheochromocytoma ( Classy smell prevention ) It is caused by endocrine disorders and chronic infections.

Examination, diagnosis and treatment

Keeping in mind the various diseases mentioned above, we ask the patient for detailed information about their condition, including appetite and food intake, and then perform the necessary examinations and tests to make a prompt diagnosis and begin appropriate treatment according to the patient's condition.

Akira Sugawara

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　一般的に、標準体重より体重が20％以上減少している場合に、るいそうと診断されますが、過去6カ月以内にもともとの体重から10％以上減った場合も、臨床上問題になります。

原因は何か

　るいそうを起こす原因にはさまざまなものがあります。大きく分けて、①食事摂取量の減少、②消化吸収障害、③栄養素利用障害、④代謝亢進(こうしん)による熱量消費の増大があげられます。

　①では、アジソン病やシーハン症候群といった内分泌疾患や、神経性食欲不振症、うつ病や統合失調症(とうごうしっちょうしょう)といった精神疾患、脳腫瘍(しゅよう)、悪性腫瘍や消耗性疾患（慢性的な炎症性疾患など）、さらには口腔(こうくう)を含めた消化管疾患に伴う食欲低下があげられます。

　②では慢性の下痢を伴う疾患、消化性潰瘍(かいよう)、慢性膵炎(すいえん)、膵腫瘍（WDHA症候群やゾリンジャー・エリソン症候群）、蛋白漏出性(たんぱくろうしゅつせい)胃腸症、吸収不良症候群や寄生虫などが認められます。

　また、③は糖尿病、④は甲状腺機能亢進症(こうじょうせんきのうこうしんしょう)や褐色細胞腫(かっしょくさいぼうしゅ)といった内分泌の疾患や慢性の感染症などで現れます。

検査と診断・治療

　前に述べたようなさまざまな疾患を念頭に入れて、食欲や食事摂取の有無をはじめとした病状を患者さんから詳しく聞いたのちに、必要な診察や検査を行って迅速に診断を行い、病態に応じた適切な治療を開始します。

菅原　明

出典　法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について　情報

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