Polyphagia [Hyperphagia]
Polyphagia 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 and physical examination
Begin your evaluation by asking the patient what he has eaten and drunk within the past 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 that may trigger overeating, such as 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.
During the physical examination, weigh the patient. Tell him his current weight, and watch for an 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 signs of dehydration, such as dry mucous membranes and poor skin turgor.
Premenstrual syndrome (PMS)
Appetite changes, typified by food cravings and binges, are common with PMS. Abdominal bloating, the most common associated finding, may occur with behavioral changes, such as depression and insomnia. A 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.
Other causes
Drugs
Corticosteroids, cyproheptadine, and some hormone supplements may increase appetite, causing weight gain.
Special considerations
Offer the patient with polyphagia emotional support, and help him understand its underlying cause. As needed, refer him and his family for psychological counseling.
Pediatric pointers
In a child, polyphagia commonly results from juvenile diabetes. In an infant 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’s experiencing a sudden growth spurt.
Book Source Details
- Book Title: Handbook of Signs & Symptoms (Third Edition)
- Author(s): Springhouse
- Year of Publication: 2006
- Copyright Details: Handbook of Signs & Symptoms (Third Edition), Copyright © 2006 Lippincott Williams & Wilkins.
Other Book Chapters Related to Excessive hunger
Read excerpts from these other book chapters related to Excessive hunger:
Medical Books Excerpts
- POLYPHAGIA
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- Polyphagia
- "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
- [ read ]
Copyright Details: Handbook of Signs & Symptoms (Third Edition), Copyright © 2008 Williams & Wilkins.
More About Causes of Excessive hunger
» Next page: Polyphagia [Hyperphagia] (Professional Guide to Signs & Symptoms (Fifth Edition))
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