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.”

POLYPHAGIA

1. Psychic desire for food. This occurs in many chronic anxiety and depressed states and is frequently associated with obesity.
2. Lack of food or a particular ingredient in food. Starvation and avitaminosis can cause polyphagia.
3. 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.
4. Increased body metabolism. Hyperthyroidism, rapid growth of adolescence, and gigantism are included in this category.
5. Increased uptake of food by the cell. Any condition associated with hyperinsulinism (functional hypoglycemia and insulinomas) is recalled in this category.
6. “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.

Book Source Details

• Book Title: Differential Diagnosis in Primary Care
• Author(s): R. Douglas Collins
• 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.

More About This Book: Title: Differential Diagnosis in Primary Care Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 0-7817-6812-8

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