Is malnutrition painful

Synonyms

Malnutrition, quantitative malnutrition

General

The human body needs daily large amounts of energythat he uses different Metabolic processes in motion to put. Also the supply of the organs and the Braincan only be guaranteed under energy consumption. In the course of this, the organism is on a regular intake of nutritional components, such as carbohydrates, Fats, Proteins, Fiber, Vitaminsand Trace elements, reliant.

Read more on the topic:Stimulate metabolism

Malnutrition is one special form of malnutrition. In the course of a too low intake of food components if the daily basal metabolic rate (i.e. the energy that various metabolic processes consume during the day) exceeds the energy suppliers absorbed.
It comes to one negative energy balancethat ultimately become a Reduction in body weight leads.

Of the general malnutrition (here there is a lack of almost all nutritional components), one can partial malnutrition in which, for example, not enough protein or carbohydrates are consumed.
Malnutrition can occur in adults, but especially in adolescents devastating effects on mental and physical development to have. In addition to the appearance of acute underweight, Short statureor mental retardation prolonged malnutrition can result Organ failure and even to Deaths to lead.

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causes

Malnutrition usually does not arise if too little food is consumed over a short period of time. The human body possesses so-called Energy reserves (for example the fatty tissue) from which it can mobilize energy. Only when Too little food for several weeks or months distorted, the first signs of malnutrition become noticeable.

  • Lack of food:
    Probably the most obvious cause of malnutrition is a Lack of food supply (financial aspect). Fundamental poverty or disproportionately high food prices can be a reason for not being able to acquire and consume enough food. In the third world in particular, malnutrition plays a central role. In these areas, many people cannot be adequately supplied with food and drinking water. The exact reasons for this are complex.
  • Malnutrition:
    In addition to this financial aspect, a wrong eating habits for many of those affected is the cause of malnutrition. The term incorrect eating habits is understood to mean one Condition in which a person eats insufficiently or unbalanced food despite having enough food. In most cases this wrong / unhealthy diet results in a so-called Malnutritionin which the organism lacks only one or more nutritional components. In contrast to common malnutrition, however, lie here other energy suppliers in sufficient quantities in front. Malnutrition is common in most cases educated and is based on a lack of knowledge about healthy and balanced nutrition. Furthermore, malnutrition can also chosen consciously become. Inadequate knowledge of vegan nutrition can also lead to malnutrition, this danger is particularly common in children (see alsoVegan diet in children). Unrealistic ideal dimensions arouse the desire to lose weight, especially in young people. For this reason, many people deliberately refrain from eating a regular and balanced diet and thereby steer themselves into malnutrition.
  • Aging process:
    Another cause of malnutrition that should not be underestimated is the aging process. In the course of aging, the human body and the metabolic processes that take place in it change. For many people, appetite steadily decreases over the course of the second half of life. Chewing and swallowing are also becoming increasingly difficult, for example due to the lack of teeth. In addition, the organism needs a different one in old age Food compilation. The decline in physical and / or mental performance also plays a decisive role in the occurrence of malnutrition in old age.
  • Diseases:
    Also Diseases and a Variety of drugs can provoke malnutrition. This fact can be justified, for example, in the fact that many diseases curb the appetite, the Make absorption of individual food components more difficult or curb their metabolism. In addition, the chewing and swallowing of food can be hindered in the course of an illness and food intake can be restricted as a result. Especially chronic diseases of the gastrointestinal tractcan be caused by the appearance of nauseaand Vomitlead to malnutrition. In the case of disease-induced malnutrition, the person affected is in a disproportion between food intake (this decreases) and energy requirement (this increases in the event of illness).
    The following diseases are particularly relevant in this context:
  • There too various drugs one strong influence on metabolism and thereby affect the basal metabolic rate, patients may have to adjust their eating habits. Drugs that can lead to malnutrition include:
  • Other causes:
    They also have perfect healthy growing children and adolescents and breastfeeding or pregnant women one increased energy requirements. Even those people who are under heavy physical exertion or under stresssufferers generally have a greatly increased energy requirement, which must be compensated for by increased food intake.

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Symptoms / consequences

The symptoms of malnutrition are versatile and do not express themselves in the same way for every person affected.
The most important factors in the appearance of certain symptoms are the extent of the malnutrition and the length of time the malnutrition has been present.

In most cases, the unwanted weight loss the first and clearest symptom of malnutrition. As a rule, those affected perceive that clothing that was once well-fitting and that certain parts of the body (especially the face and hands) collapse.
Then in the course of time various deficiency symptoms in the area of ​​the individual organ systems. Most people will notice the onset of immediately after the onset of weight loss paleness, weakness, more constantfatigueand Trouble sleeping. It can also be in the wake of malnutrition severe limitations in performance be recorded. In most cases, those affected also suffer from pronounced lack of drive.

Especially the skinreacts particularly sensitively to deficiencies of any kind. Acute malnutrition can already be avoided for this reason very early due to the appearance of skin changes detect. Next noticeable discoloration can a delayed wound healing be an indication of malnutrition. In the field of Mucous membranes observe many of those affected painful, swollen lesions. Especially the Lips and corners of the mouth (so-called Angular rhinitis) are often affected. It also occurs in the course of malnutrition severe inflammation of the lining of the mouth and gums. Furthermore, typical changes and complaints arise in the area of ​​the nails and hair. Severe hair loss and the Formation of grooves and spots on the fingernails are not uncommon in malnourished patients.

After a while, the lack of energy begins internal organs and the hematopoietic structures to tug.
Consequence is a acute decrease in all blood cells with occurrence of Anemia. Sooner or later this leads to a decreasing oxygen supply to the organs, fatigue, Difficulty breathing (Drop in red blood cells), one immunodeficiency With increased susceptibility to infection (Drop in white blood cells) and one Decrease in blood platelets with an increased tendency to bleed.

Also the Musculaturesuffers increasingly in the course of malnutrition. In order to mobilize energy reserves, the malnourished organism begins with the Reduce muscle mass. Especially in the field of Temples and the Upper armscan be done quite quickly Atrophies observe. In addition, there is a Muscle weakness with faster fatigue of the remaining muscle fibers. In later stages it shows itself Muscle loss also in the heart and the Respiratory muscles. Consequently the efficiency of the heart decreases, it comes to Cardiac arrhythmias, Heart failureand to Bradycardia. These symptoms and the occurrence of breathing problems should be taken seriously as a matter of urgency. A visit to the doctor is strongly recommended!

Furthermore, the eyesaffected by the effects of malnutrition very early on. Patients who cannot meet their energy needs for a long period of time suffer from Visual disturbances and night blindness.

In the field of boneit happens especially with children and adolescents Stunted growth and osteoporosis.

diagnosis

A first indication of the presence of malnutrition can be Self-testswhich the data subject must answer honestly. People who suspect they are malnourished should try to answer two questions:
1. Have I accidentally lost weight in the past few months? (We are talking about several kilograms here)
2. Have I eaten significantly less food or eaten very unbalanced in the last few months?
Patients who can answer both questions clearly with “yes” should consult a doctor as soon as possible and let him rule out malnutrition.
Already the detailed one Doctor-patient conversation provides the practitioner with an initial insight into the nutritional behavior of the person concerned. In addition to food intake, the following points are in the foreground:

  • Current complaints (symptoms)
  • the life situation
  • Discomfort when chewing and swallowing
  • the stool behavior
  • Underlying diseases
  • past treatments and operations.

Following the doctor-patient conversation (briefly: anamnesis), a detailed physical examination where the person is examined from head to toe.

They also find various Screening tests (especially the so-called Nutritional Risk Screening; short: NSR 2002) in everyday clinical use. The NSR 2002 is divided into several sections. In the first section, three questions must be answered:

  • In which area is the Body mass index (BMI) of the data subject?
    A BMI less than 20.5 kg / m2 is classified as underweight.
  • Has the person lost weight in the past three months?
  • Has the person concerned eaten less and / or in an unbalanced manner in the past few weeks?

According to this screening, malnutrition is already present if only one of these three questions is answered with “yes”.
The medical world divides the question of whether this screening method is reliable.
Since the BMI as such is rather controversial, the question remains whether it can actually provide reliable information about a person's nutritional situation. The fact is that the body mass index correlates body weight with body size, but does not place any value on the body fat percentage. As a result, for example, athletic people who weigh a little more due to their muscles can have a higher BMI.

Laboratory methods can also provide indications of malnutrition. For example, read about this: Urea decreased

therapy

To successfully treat malnutrition you must first their exact cause is determined become.
The main goal of therapy is Supply of the organism with a sufficient amount of energy suppliers.

Since the causes of malnutrition can in many cases also be traced back to psychological factors, a appropriate psychotherapy be initiated. Help with most of those affected Meal plans regain a normal relationship with food and ingestion and put an end to malnutrition. When creating such a menu, the patient's preferences and the chewing and swallowing options should be taken into account.
In addition to food intake, the Providing the body with sufficient fluids (at least 1.5 to 2 liters per day) don't miss out.
However, since such a menu is not always sufficient to lead those affected out of the malnutrition, additional special drink-food preparations be distorted. These usually have a very high percentage of calories (i.e. energy units) and can usually cushion the organism's lack of energy more quickly. In addition, the intake of certain food components can be influenced well by this drinking food. Special solutions have different proportions of carbohydrates, proteins and protein.
In extreme cases of malnutrition, however, successful treatment cannot be guaranteed even with high-calorie drinks packs. In these patients, the artificial nutrition become necessary. With this type of diet, a thin tube (called a nasogastric tube) is inserted through the nose or directly through the abdominal wall and placed in the stomach. In this way, a high-calorie porridge can be introduced directly into the stomach and the absorption of energy sources can be increased.

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Additional information

More information on the topic Malnutrition you'll find here:

Further General topicsyou might also be interested in:

You can find an overview of the topics of internal medicine that have appeared so far at Internal medicine A-Z.

Quality assurance by: Dr. Nicolas Gumpert | Last change: 03.04.2021