POLYPHAGIA
POLYPHAGIA: Excerpt from Differential Diagnosis in Primary Care
The causes of increased appetite are similar to those of obesity and
can be recalled with the help of physiology. The appetite may be
based on a psychic desire for food, a lack of food or a particular vitamin,
impaired intake of food, an increased metabolism of the body (and
consequently an increased need for food), increased uptake of food by the
cell, and inability of the cell to absorb food, causing “cell starvation.”
-
Psychic desire for food. This occurs in many chronic anxiety and
depressed states and is frequently associated with obesity.
-
Lack of food or a particular ingredient in food. Starvation and
avitaminosis can cause polyphagia.
-
Impaired uptake of food. Rapid mobility of food in gastric
hypersecretion and intestinal bypass as well as preempting of food by
intestinal worms may cause polyphagia on this basis.
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Increased body metabolism. Hyperthyroidism, rapid growth of
adolescence, and gigantism are included in this category.
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Increased uptake of food by the cell. Any condition associated
with hyperinsulinism (functional hypoglycemia and insulinomas) is
recalled in this category.
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“Cell starvation.” Here diabetes mellitus and acromegaly are
associated with diabetes where the cell cannot absorb glucose.
Approach to the Diagnosis
Association with other symptoms is the key to a definitive diagnosis of
polyphagia. Thus, polyphagia and obesity suggest an islet cell adenoma.
Polyphagia with polyuria, polydipsia, weakness, and weight loss suggest
hyperthyroidism or diabetes mellitus.
The laboratory workup should include thyroid function studies, a skull x-ray
for pituitary size, glucose tolerance tests, and, possibly, a 48-hour fast
with frequent blood sugar determinations. An MRI of the pituitary is the
best way to reveal microadenomas.
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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