Anorexia nervosa: symptoms and treatment
Anorexia nervosa is a disease that is more common in adolescents and young people, more often female. This pathological process is characterized by deliberate refusal of food, which ultimately leads to a critical decrease in body weight and complete exhaustion. In some cases, an irreversible pathological process takes place, which leads to a lethal outcome.
It should be understood that this disease is of a psychological nature. In this case, a person does not adequately and adequately assess his body, even at a critically low weight, he believes that he has extra weight, and against this background refuses food completely or adheres to a rigid diet. Proceeding from this, it can be said that anorexia nervosa in adolescents and adults requires a comprehensive approach to treatment. According to the International Classification of Diseases of the Tenth Revision (ICD-10), this disease is assigned the code F 50.0.
Anorexia nervosa can be caused by the following etiological factors:
- psychological impact on a person — insults, negative statements about his figure, weight
- psychological illnesses
- pathological fear of gaining weight
- the impact of the environment
- disharmonious teenage crisis.
Separately, there are risk factors in the development of this pathological process:
- genetic — the gene 1p34 can trigger the development of this disease, which is activated in case of severe stress and excessive nervous overload
- Family — at risk people who have family members with a given disease
- personal — low self-esteem, increased susceptibility to inadequate criticism from outside, moral pressure
- anthropological — there is also a fear of normal nutrition when overcoming a desire
- social — imitation of someone, a fashion for excessive leanness.
Most often, the development of such a violation is due precisely to the psychological impact from the outside and the desire to follow fashion trends.
There are four degrees of development of this pathological process:
- predanoreksicheskaya — there are thoughts about the «fullness», the ugliness of his figure, a person begins to look for ways to get rid of «extra» kilograms as soon as possible
- anorexic — almost complete fasting, weight drops to a critical minimum, but a person does not stop but, on the contrary, tightens the diet
- cachectic — almost complete absence of adipose tissue and exhaustion. An irreversible process of degeneration of the internal organs begins. In most cases, this stage is observed one year after the onset of this pathological process.
At the last stage of the development of the disease, there is a high risk of death, as against the background of extreme exhaustion of the body and the degeneration of internal organs, there are accompanying diseases. At the same time, it should be noted that the protective functions of the body are almost completely absent, which leads to complications.
Symptoms of anorexia nervosa, as a rule, appear in the first-second stage in the form of such a clinical picture:
- the categorical rejection of food, which manifests itself gradually — from exclusion from the diet of nutritious food to the consumption of only mineral water
- pallor of the skin, hair loss, brittle nails
- frequent dizziness;
- fainting states
- heart rhythm disorder
- feeling cold all over the body
- exacerbation of existing chronic diseases
- violation of the menstrual cycle, and as the pathological process worsens, a complete absence of menstruation
- excessive sensitivity to physical activity
- Violations of a psychological nature — sudden mood swings, apathy to everything around, depressive state, suicidal tendencies
- weakness, drowsiness.
Since the syndrome of anorexia nervosa is quite often observed in adolescents, it is necessary to distinguish separately some specific symptoms of the development of this disease:
- discontent with his figure, fear of obesity
- Constant calorie counting
- Radical diets
- taking laxatives and diuretics, special drugs for weight loss
- change in behavior — a teenager may abandon his usual pastime
- Apathy to everything around can be observed
- sudden mood swings, aggression, irritability
- complaints of a constant sensation of coldness in the hands and feet
- the adolescent sharply denies his pathological thinness
- aversion to food, causing vomiting even with a minimal amount of food eaten.
Initially, the therapist conducts a conversation with the patient about complaints and his relationship to his ailment, then a family member clarifies the anamnesis of the disease and life. After this, a physical examination of the patient is carried out. To confirm the diagnosis:
- a common and expanded biochemical blood test
- general urine analysis
- Thyroid hormone analysis
- CT of the brain;
- Ultrasound of the abdominal cavity.
The exact diagnosis program will depend on the current clinical picture. Based on the results of the examination, the doctor will determine the stage of the disease and prescribe the most effective course of treatment.
The indication for hospitalization with anorexia nervosa is the 3-4 degree of development of the pathological process. Therapy with such a disease should be complex, with drug treatment and mandatory diet.
Medication may include the following drugs:
- solutions to restore the water-electrolyte balance.
As for the diet, at the initial stage of treatment should be included in the diet only light, moderately high-calorie meals. As the patient’s condition improves, you can increase the calorie content of dishes and the volume of portions. Also it is necessary to take into account such recommendations of the patient’s nutrition:
- In particularly severe cases, parenteral nutrition is administered
- the food should be only liquid, at most a puree
- Food intake should be frequent (5-6 times a day), but in small portions. Otherwise, the stomach can not digest so much food
- optimal drinking regime;
- it is recommended to include in the diet nutritional supplements that contain trace elements;
- if the patient’s condition is not critical, then the diet table No. 11 is prescribed for Pevzner.
In general, the diet is prescribed individually, depending on the stage of the disease, clinical indicators and the general condition of the patient.
Forecast and possible complications
If the treatment is started in time, then the development of serious complications can be avoided. Otherwise, the following dangerous changes are likely to occur:
- dysfunction of the central nervous system, which is due to inadequate brain nutrition;
- reduction of the body’s protective functions, against which the person often suffers;
- a violation of mineral metabolism
- acute heart failure;
- kidney failure.
In general, against the background of an exhausted organism, virtually any pathological process can develop.
Preventive recommendations include:
- Proper, balanced nutrition
- elimination of negative psychological impact
- In case of severe emotional conditions, contact a psychoneurologist.
If you feel unwell, both physically and psychologically, you should consult your doctor and not self-medicate.