Cachexia is a state of severe wasting of the human body, usually observed in patients in the advanced stage of a chronic disease, most often cancer. How to recognize kachesia? How is the treatment performed when the patient's organism is exhausted?

Cachexia( wasting the organism ) can be a complication of both the disease itself and long-term specialist treatment. Deep malnutrition leads to a significant loss of body weight, muscle atrophy, weakness, as well as malaise, isolation from the environment and depression.

In many cases, the development of cachexia affects the course of treatment of patients, significantly reduces the quality of life and worsens the prognosis, as well as leads to a shortened survival time and increases the risk of death in patients suffering from neoplastic diseases.

Cachexia (wasting of the organism): causes

The causes of cachexia include cancer that lead to insufficient food intake, malabsorption and metabolic disorders.

Significant weight loss and extreme malnutrition are observed in patients suffering from gastrointestinal cancers (especially its upper section, i.e. esophageal cancer and gastric cancer) and pancreatic cancer, as well as other chronic diseases, both viral (viral hepatitis , AIDS) and those leading to kidney failure, heart failure or lung failure.

Whether and possibly when extreme wasting of the body develops is mainly influenced by the type of cancer, its location, clinical stage, and the type of therapy used in oncological treatment.

It should be remembered that a significant loss of body weight and reluctance to eat in a short time lead to a deterioration of the he alth of a chronically ill patient, which may even lead to exclusion from the drug program or postponing the therapy and may lead to his early death.

Cachexia (wasting of the organism): symptoms

The most frequently observed symptoms in debilitated patients include unintentional, significant weight loss. Patients in the advanced stages of chronic disease often become infected withloss of appetite and the desire to eat even your favorite foods.

Repeated nausea and vomiting are also not conducive to regular food intake. The use of cancer drugs and chemotherapy may contribute to the decrease in appetite. They often cause very painful and difficult to swallow lesions located on the mucous membranes of the mouth, as well as dryness and fungal lesions within them.

There is a significant reduction in the amount of adipose tissue and loss of muscle mass, visible by the patient himself and his family. Patients with debilitating organism are more susceptible to infections due to decreased immunity.

People lying down may experience massive swelling around the feet, shins, lumbar spine and hands, which result from insufficient supply and excessive loss of protein.

The sick person becomes weak, sleepy, chronically tired, he has no strength or will to do anything. Repeated dizziness, fainting, fainting, a feeling of heart palpitations, as well as shortness of breath may indicate worsening anemia (anemia).

Progressive wasting and weight loss worsen the mental state of patients. Many debilitated patients in the advanced stage of chronic disease rely on their caregivers or family for their daily activities, are depressed in mood, are emotionally unstable, and suffer from depression. In such a situation, it is worth asking a psychologist for help and an interview.

Cachexia (wasting of the organism): diagnosis

The wasting of the organism is assessed on the basis of the unintentional, progressive weight loss of the patient and the accompanying clinical symptoms. Additionally, laboratory tests can be performed to assess the patient's blood count, especially the content of erythrocytes and leukocytes, as well as the concentration of prealbumin, albumin, total protein and transferrin in the blood serum.

So far, no studies have been described in the literature that would allow for unequivocal confirmation of the development of cachexia, the diagnosis is made on the basis of clinical symptoms presented by the patient, especially the percentage of weight loss measured before the onset of the disease.

Weight loss greater than 5% over 6 months is considered to be a cause for concern, especially with associated muscle wasting and metabolic disturbances.

This is an early symptom of an eating disorder and requires appropriate nutritional treatment.

Cachexia (wasting of the organism): healing

Treatment of an emaciated patient is difficult, based mainly on the treatment of the underlying disease, whether it is cancer or another diseasea chronic medical condition. However, it is also necessary to introduce a balanced, high-protein and high-calorie diet, and sometimes also pharmacotherapy.

The most beneficial for the patient is enteral nutrition (i.e. through the gastrointestinal tract), which includes both the administration of meals by the oral route and the use of industrial liquid oral diets, as well as nutrition through a nutritional fistula or a tube inserted into the stomach or small intestine.

It is very important that a patient in the advanced stage of a chronic disease is fed orally for as long as possible, so it is worth taking care of the consistency of meals acceptable to the patient, as well as the taste and size of the portions of the food consumed.

Provide meals that the patient likes and eats most willingly, preferably in small portions, but often (7-8 times a day). In order to establish a properly balanced diet, it is worth seeking help and advice from a dietitian.

There are also specialized industrial preparations and nutrients on the market for feeding patients who refuse to eat.

They can be used instead of, or between meals, because they are rich in calories, easily digestible, highly digestible and provide the body with all the necessary nutrients. Contraindications to enteral nutrition include gastrointestinal obstruction, intestinal ischemia, as well as severe shock and malabsorption.

When enteral nutrition becomes inadequate, consider adding parenteral nutrition to your therapy. It consists in delivering nutrients in the form of a specially prepared mixture directly to the bloodstream.

Intravascular catheters are used for this purpose, inserted into central or peripheral veins, as well as arteriovenous fistulas. Nutrition of a debilitated patient can also be supported by pharmacotherapy, which mainly consists in administering drugs that stimulate appetite, as well as substances that act as an antiemetic and accelerate the intestinal passage.

One should not forget about rehabilitation and regular physical exercises adjusted to the intensity of the patient's abilities. They prevent the formation of pressure ulcers, contractures and muscle atrophy.

Cachexia (wasting of the organism): complications

The patient with cachexia often cannot continue the previously planned therapy of a chronic disease or oncological treatment due to the increased risk of life-threatening complications of the administered agents, as well as reducing their effectiveness.

Excessive weight loss of the patientstruggling with neoplastic disease also lowers the prognosis for a cure. In such a case, drug therapy is usually discontinued and any surgical procedure is postponed until the patient's clinical condition improves.

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