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Emaciation

Emaciation

Emaciation is a health condition characterized by severe degree of weight loss due to loss of excess amount of protein and subcutaneous fat throughout the body. Emaciation is considered to be one of the most severe forms of malnutrition. The most common presenting symptom of emaciation is extreme thinness to such an extent that even the bone structures can be easily delineated under the skin giving the affected person a “gaunt” appearance.
The most common underlying cause of emaciation is poverty and famine, however in several medical conditions the primary disease may interfere with absorption of food in the digestive tract leading to emaciated look.
The main way to treat emaciation is to gradually increase the daily calorie intake so that the person can attain normal body weight.
Symptoms
Emaciation usually presents with an extreme degree of thinning of limbs both upper and lower, upper part of the body and the buttocks. Weight loss could be so extreme that the affected person usually has a skeleton like appearance with almost complete loss of fatty substances and muscle mass. All over the body the skin looses its normal appearance and eventually become dry and translucent to such an extent that the underlying blood vessels become somewhat visible from outside.
The face gradually becomes very much thin with somewhat vacant appearance, the eye sockets become so much sunken that as such eyes appear bulged, the scalp skin also becomes very dry along with severe degree of loss of hair, the very little remaining hair loses its normal shine, different bones in the body like the collar bones, rib cage, etc. gradually become very much prominent, the stomach on the other hand appear bloated due to formation of large amount of gas, severe degree of dehydration often leads to excessive drying and coating of tongue and bad breath also become a common associated feature.
Affected person also suffers from extreme degree of tiredness and there is almost no physical activity. Other than these symptoms emaciation also leads to severe degree of imbalance of different electrolytes, low level of hemoglobin (anemia), inadequate functioning of the immune system (immunocompromisation) due to fall in the different blood cells, mainly lymphocytes, accumulation of fluid leading to fluid collection in the area surrounding the lungs (pleural cavity) known as pleural effusion and lower legs both due to inadequate functioning of kidneys to remove water and different waste products and also due to protein deficiency.
Causes
Poverty and malnutrition is the most common cause of emaciation in the Africa and other third world countries. In some cases of emaciation there is deficiency of a particular type of nutrient leading to a particular set of symptoms.
There are two particular forms of emaciations seen in children due to Marasmus and Kwashiorkor diseases. Marasmus occurs following deficiency of protein, fats and carbohydrates whereas Kwashiorkor is more common in children with mainly protein deficiency. Kwashiorkor is more common in children who have recently weaned and the condition usually affects the upper part of the body.
Some degree of emaciation is also seen in vitamin deficiency as in beriberi, due to Vitamin B1 deficiency and pellagra due to vitamin B3 deficiency.
Other systemic health conditions other than malnutrition may also lead to emaciation. These are infectious diseases like malaria, cholera or parasitic infections, prolonged and repeated attacks of diarrhea, different types of cancer, intake of anti cancer drugs, chronic lead poisoning, eating disorders like anorexia nervosa etc.
Treatment
The mainstay of treatment is to restore normal body weight and correct associated dehydration with adequate supplementation of protein, fat, carbohydrates and other micronutrients.
The process of introducing the affected person to normal balanced diet should be gradual to avoid complications like vomiting, regurgitation etc. One should start with liquid food and then gradually move to solids.
Other than dietary modifications underlying other health problems, if any, should also be corrected. The affected person also requires adequate amount of rest.

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