Hypotrophy

Hypotrophy is a chronic nutritional disorder characterized by varying degrees of weight loss. As a rule, young children suffer from malnutrition.

Etiology, pathogenesis

The disease is polyetiological. There are congenital (prenatal) and acquired (postnatal) malnutrition. Congenital malnutrition is most often caused by maternal diseases or associated with intrauterine hypoxia, fetal infection, genomic and chromosomal mutations.

Among the causes of acquired malnutrition, exogenous and endogenous are distinguished. The first include nutritional factors (hypogalactia in the mother, incorrectly calculated diet during artificial feeding, unilateral feeding, etc.), pyloric stenosis and pylorospasm, drug poisoning (hypervitaminosis D, etc.), infections of the gastrointestinal tract, deficiencies in care, regimen, education etc. Endogenous causes of malnutrition can be malformations of the gastrointestinal tract and other organs, damage to the central nervous system, hereditary metabolic abnormalities and immunodeficiency conditions, endocrine diseases, etc.

The pathogenesis of malnutrition is based on a decrease in the utilization of nutrients with disruption of the processes of digestion, absorption and assimilation under the influence of various factors.

There are I, II and III degrees of severity of malnutrition.

Clinical picture

Hypotrophy of the first degree is characterized by a loss of body weight of no more than 20% of that required by age. The subcutaneous fat layer on the abdomen becomes thinner, and tissue turgor decreases. The curve of body weight gain is flattened. Other indicators are usually within normal limits or slightly reduced.

With II degree malnutrition, the loss of body weight is 25-30% compared to the age norm. The subcutaneous layer is preserved only on the face; it is especially thin on the stomach and limbs. The skin is dry, easily wrinkles, and hangs down in some places. There is growth retardation, appetite decreases, the child becomes irritable, loses previously acquired skills, and thermoregulation is impaired. The stool is unstable: “hungry” stool (scanty, dry, discolored, with a sharp and unpleasant odor) is replaced by dyspeptic stool (green, with undigested food particles, with mucus).

With grade III malnutrition, the loss of body weight is more than 30% of what it should be before age. There is no increase in body weight, the child is significantly stunted in growth. Externally - an extreme degree of exhaustion, the skin is pale gray in color, the subcutaneous fat layer is completely absent. The mucous membranes are pale, dry, in the mouth there are elements of candidal stomatitis (thrush).

The diagnosis of malnutrition is usually not difficult. It is much more difficult to find out the causes of malnutrition.

Treatment of patients should be comprehensive and include measures aimed at eliminating or correcting cause-significant factors, diet therapy, prescription of restorative procedures, enzymes and symptomatic drugs, elimination of foci of infection, and vitamin therapy.

The prognosis depends on the cause that led to malnutrition and the possibilities of eliminating it. With primary malnutrition of the third degree, the prognosis is always serious; mortality rate is up to 30%.

Prevention consists of ensuring proper feeding and care of the child, timely diagnosis and treatment of diseases.

Hypotrophy is a disorder of tissue nutrition in various pathological conditions. Dystrophic changes affect not only muscles and skin, but also internal organs, including the heart and kidneys. Eating disorders develop during prolonged fasting, for example, with extreme forms of exhaustion in patients with anorexia, obesity, as well as with impaired absorption of nutrients in the intestine or rejection of foreign proteins.

Hypotrophic and dystrophic processes are involved in the formation of heart and kidney failure in patients with vascular and liver atherosclerosis. Malnutrition leads to chronic metabolic disorders. The main symptom is a feeling of hunger, which becomes persistent in a person. Patients with eating disorders are forced to eat more than usual. Symptoms of malnutrition resemble those during fasting, after which the patient cannot eat his usual food. With further progression of the process, a sharp emaciation occurs, to the point that “there is no strength to keep my eyes open.” The disease leaves an imprint on the patient’s consciousness and forces them to react even to insignificant stimuli and accelerate the response. Patients lose weight within a few months while still remaining lucid.