Polyphagia
Polyphagia: Excerpt from Signs & Symptoms: A 2-in-1 Reference for Nurses
Polyphagia, also called hyperphagia, refers to voracious or excessive eating. This common symptom can be persistent or intermittent, resulting primarily from endocrine and psychological disorders as well as the use of certain drugs. Depending on the underlying cause, polyphagia may cause weight gain.
History
Begin your evaluation by asking the patient what he has eaten and drunk within the last 24 hours. (If he easily recalls this information, ask about his intake for the 2 previous days, for a broader view of his dietary habits.) Note the frequency of meals and the amount and types of food eaten. Find out if the patient’s eating habits have changed recently. Has he always had a large appetite? Does his overeating alternate with periods of anorexia? Ask about conditions thatmay trigger overeating, suchas stress, depression, or menstruation. Does the patient actually feel hungry, or does he eat simply because food is available? Does he ever vomit or have a headache after overeating?
Explore related signs and symptoms. Has the patient recently gained or lost weight? Does he feel tired, nervous, or excitable? Has he experienced heat intolerance, dizziness, palpitations, diarrhea, or increased thirst or urination? Obtain a complete drug history, including the use of laxatives or enemas.
Physical assessment
During the physical examination, weigh the patient. Tell him his current weight, and watch for any expression of disbelief or anger. Inspect the skin to detect dryness or poor turgor. Palpate the thyroid for enlargement.
Medical causes
Anxiety
Polyphagia may result from mild to moderate anxiety or emotional stress. Mild anxiety typically produces restlessness, sleeplessness, irritability, repetitive questioning, and constant seeking of attention and reassurance. With moderate anxiety, selective inattention and difficulty concentrating may also occur. Other effects of anxiety may include muscle tension, diaphoresis, GI distress, palpitations, tachycardia, and urinary and sexual dysfunction.
Bulimia
Most common in women ages 18 to 29, bulimia causes polyphagia that alternates with self-induced vomiting, fasting, or diarrhea. The patient typically weighs less than normal but has a morbid fear of obesity. She appears depressed, has low self-esteem, and conceals her overeating.
Diabetes mellitus
With diabetes mellitus, polyphagia occurs with weight loss, polydipsia, and polyuria. It’s accompanied by nocturia, weakness, fatigue, and such signs of dehydration as dry mucous membranes and poor skin turgor.
Migraine headache
Polyphagia sometimes precedes a migraine headache. The individual may experience changes in appetite or food cravings. Other prodromal signs and symptoms include fatigue, nausea, vomiting, and a visual aura. Light and noise sensitivity may also occur.
Premenstrual syndrome
Appetite changes, typified by food cravings and binges, are common with premenstrual syndrome. Abdominal bloating, the most common associated finding, may occur with behavioral changes, such as depression and insomnia. Headache, paresthesia, and other neurologic symptoms may also occur. Related findings include diarrhea or constipation, edema and temporary weight gain, palpitations, back pain, breast swelling and tenderness, oliguria, and easy bruising.
Thyrotoxicosis
Thyrotoxicosis can produce weight loss despite constant polyphagia. Other characteristics include weakness, nervousness, diarrhea, tremors, diaphoresis, and dyspnea. The patient’s hair and nails are thin and brittle, and his thyroid is enlarged. He may also exhibit palpitations, tachycardia, heat intolerance, exophthalmos, and an atrial or ventricular gallop.
Other causes
Drugs
Corticosteroids and cyproheptadine may increase appetite, causing weight gain.
Special considerations
Monitor the patient’s eating habits. Weigh him once or twice a week to monitor weight. Refer the patient to a registered dietitian for nutritional counseling, if indicated.
Pediatric pointers
In children, polyphagia commonly results from juvenile diabetes. In infants ages 6 to 18 months, it can result from a malabsorptive disorder such as celiac disease. However, polyphagia may occur normally in a child who is experiencing a sudden growth spurt.
Patient counseling
Offer the patient with polyphagia emotional support, and help him understand its underlying cause. As needed, refer the patient and his family for psychological counseling.
Pictures
Book Source Details
- Book Title: Signs & Symptoms: A 2-in-1 Reference for Nurses
- Author(s): Springhouse
- Year of Publication: 2007
- Copyright Details: Signs & Symptoms: A 2-in-1 Reference for Nurses, Copyright © 2007 Lippincott Williams & Wilkins.
More About Eating Disorder not Otherwise Specified (ENDOS)
More Medical Textbooks Online about Eating Disorder not Otherwise Specified (ENDOS)
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Medical Books Excerpts
- ANOREXIA
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
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- POLYPHAGIA
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- Anorexia
- "In A Page: Pediatric Signs and Symptoms" (2007)
- [ read ]
- ANOREXIA
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- Anorexia
- "Handbook of Signs & Symptoms (Third Edition)" (2006)
- [ read ]
- Anorexia
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
- [ read ]
- Anorexia
- "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
- [ read ]
- Anorexia
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
- Polyphagia
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
- Anorexia
- "Nursing: Interpreting Signs and Symptoms" (2007)
- [ read ]
- ANOREXIA
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Anorexia (Nursing: Interpreting Signs and Symptoms)
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