POLYPHAGIA

POLYPHAGIA: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Is there associated polydipsia, polyuria, and weight loss? The presence of these symptoms would suggest diabetes mellitus or hyperthyroidism.
2. Is there associated weight gain? This symptom would indicate that the patient has an insulinoma, Cushing's disease, or idiopathic obesity.
3. Is there associated anxiety, depression, or other emotional problems? These symptoms would signal that the polyphagia is related to bulimia, hysteria, or other psychic disorder.
4. Is there associated diarrhea? This would suggest the disorder is related to a malabsorption syndrome, intestinal bypass, or GI fistula.

DIAGNOSTIC WORKUP

The basic workup of polyphagia should include a CBC, sedimentation rate, chemistry panel, thyroid profile, and stool for ovum and parasites.

If diabetes mellitus is suspected, a glucose tolerance test may be done. If Cushing's disease is suspected, a serum free cortisol should be done. If an insulinoma is suspected, plasma insulin or C-peptide levels may be done, or the patient may be hospitalized for a 72-hr fast with frequent blood sugar determinations. If hyperthyroidism, diabetes mellitus, insulinoma, and intestinal disorders have been ruled out, a referral to a psychiatrist would be indicated.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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