Cachexia is a pathological weight loss that can occur in the context of serious illness. In addition to the body’s fat deposits, this phenomenon also attacks the physique fat in the organs. One treatment option is artificial feeding.
What is cachexia?
Cachexia is usually caused by illness or a certain age. In particular, chronic wasting diseases such as cancer, type 1 diabetes, African sleeping sickness or rheumatoid arthritis are associated with cachexia. See AbbreviationFinder for abbreviations related to Cachexia.
Cachexia is a term used to describe weight loss that is pathological. In the case of tumor diseases, for example, there is a pronounced weight loss in the form of tumor cachexia. The body mass index falls below a value of 18 in cachexia. The body fat percentage decreases by at least five percent within five months. The overall weight loss during this period is more than two percent. Severe cachexia is often interpreted as a warning of imminent death.
A refractory cachexia is present as soon as the pathological weight loss can no longer be influenced therapeutically, for example in the final stages of tumor diseases. Life expectancy in refractory cachexia is only a few months. Inanition, which is understood as emaciation, must be distinguished from cachexia. That’s what we’re talking about as long as the body’s vital building fat isn’t affected by the weight loss. In the case of cachexia, not only the fat deposits of the body are attacked, but also the muscles and organs.
Cachexia is usually caused by illness or a certain age. In particular, chronic wasting diseases such as cancer, type 1 diabetes, African sleeping sickness or rheumatoid arthritis are associated with cachexia. The same applies to persistent diseases of the gastrointestinal tract, such as enteritis or pancreatitis.
In the context of these diseases, the nutrient absorption in the gastrointestinal tract can no longer take place to the usual extent. Just as often, chronic cardiac insufficiency, renal insufficiency or lung diseases trigger cachexia and thus weaken the organism. We are then talking about cardiac, renal or pulmonary cachexia. Under certain circumstances, cachexia can also be due to malnutrition or even an eating disorder such as bulimia.
Senile cachexia, on the other hand, is a sign of old age that is often associated with the terminal phase of death. Sometimes cachexia is also associated with intoxication. Alcoholism, drug addiction and chronic mercury poisoning, for example, can trigger the phenomena.
Symptoms, Ailments & Signs
The first signs of cachexia are already the appearance of the affected person. The contours of the bones become visible bit by bit. The eyes are deep and the cheeks deform into hollow cheeks. These phenomena are related to the degradation of the retrobulbar fat deposits and the structurally provided cheek fat pad. Organic disturbances soon appear.
In the late course, for example, atrophic cardiac insufficiency often occurs. The bone marrow turns into gelatinous marrow. As part of this, the fatty building blocks of the anatomical structure are replaced with a serous fluid and take on a grayish color. The patient becomes progressively weaker. In the late course, the lack of strength may turn into lethargy, i.e. into drowsiness with an increase in the stimulus threshold. Since muscles also shrink as part of cachexia, the heart muscle may be attacked in the final stages. The damage to organs is irreversible and can cause death.
Diagnosis & course of disease
The doctor makes the diagnosis of cachexia as part of the visual diagnostics and the BMI measurement. To assess the extent of pathological weight loss, the anamnesis helps. However, the organs and spinal cord may also be examined for involvement to complete the picture. The course of the disease in this phenomenon is highly dependent on the underlying cause and the time of diagnosis.
If the cachexia has already attacked the organs at the time of diagnosis, then this means a rather poor prognosis. As long as there is no organic damage and the cause of cachexia can theoretically be eliminated, full recovery is possible. So the prognosis in this case is good. Self-will, hunger and cooperation on the part of the patient are also often rated as prognostically favorable factors.
Cachexia causes the patient to lose a lot of weight. Being underweight is a very unhealthy condition for the body, which must be avoided or remedied in any case. The internal organs can also be damaged, resulting in irreversible consequential damage for the patient.
The external appearance is also severely restricted by cachexia, so that most patients do not feel comfortable with their bodies and are ashamed of them. This can lead to inferiority complexes or low self-esteem. The muscles also shrink, resulting in a reduction in the patient’s ability to exercise. Those affected appear tired and exhausted.
If vital organs are irreversibly damaged, the patient may even die if no treatment is initiated. The heart can also be affected, leading to cardiac death. As a rule, a causal treatment of the cachexia must take place in any case. However, it cannot be generally predicted whether the disease will progress positively. The life expectancy may be reduced.
When should you go to the doctor?
Unusual weight loss should be evaluated by a doctor. People who are experiencing weight loss that may be associated with an eating disorder or other medical condition are best advised to speak to their healthcare practitioner. At the latest when further warning signs such as increasing weakness and exhaustion appear, medical advice is required. The person concerned should also visit a doctor’s office if psychological problems are added or are a possible trigger for the symptoms.
If the weight loss causes physical or mental deficiency symptoms, a doctor must be consulted on the same day. If there is an acute risk of falling or if there are problems with the cardiovascular system, the relatives should call the emergency doctor. Cachexia occurs mainly in chronic diseases such as cancer, type one diabetes or rheumatoid arthritis as well. Chronic renal insufficiency, heart failure and lung diseases are also possible risk factors. Affected patients should see a doctor immediately. In addition to the family doctor, an internist or a therapist for eating disorders is the right contact person. Children should be presented to a pediatrician or child psychologist.
Treatment & Therapy
When cachexia is present, treatment is usually based on the cause. Ultimately, to cure cachexia, the doctor must eliminate the cause. In the case of diseases, this means a cure for the causal disease. This goal is approached via the disease-specific therapy steps. In the case of serious illnesses such as cancer or cardiac insufficiency, the treatment of cachexia turns out to be rather difficult.
For cachexia due to malnutrition, treatment includes dietary changes and gradual transition to a healthy diet. Self-induced cachexia due to eating disorders or alcoholism may require treatment by a psychotherapist. If oral intake of food is not possible or there is an absorption disorder in the gastrointestinal tract, the doctor initiates parental forms of nutrition.
The patient is given a small-molecular solution of nutrients into the bloodstream via an infusion. In this way, the gastrointestinal tract can be bypassed and the vital nutrients are available to the organism again. In the case of refractory cachexia or cachexia in the terminal phase of death, the patient’s symptoms can no longer be alleviated by measures such as artificial nutrition. In this phase, no meaningful treatment can take place.
Outlook & Forecast
Since cachexia are merely symptoms of underlying diseases, they have no prognosis in themselves. However, they sometimes have a significant impact on the prognosis of the diseases they trigger. The so-called tumor cachexia, for example, says a lot about whether the prognosis of a cancer patient looks good or rather bad. This type of cachexia often occurs in the course of cancer treatment with chemotherapy and worsens the prognosis because it robs the affected patient of important energy resources that he needs to better cope with the consequences of his therapy.
Cachexia can also occur quickly in eating disorders, especially in anorexia and bulimia. These diseases are not life-threatening at first, but can quickly become so if cachexia has already occurred in the affected patient. If he doesn’t get professional help now, the internal organs will be damaged. This damage can be permanent or, in the worst case, fatal.
Most other forms of cachexia are also not beneficial for a person’s health. Age cachexia, for example, is often an indication of the waning strength of an aging person. Cachexia in third world countries that occurs due to famine also suggests dangerous health conditions that can quickly lead to life-threatening problems.
Self-inflicted cachexia in the context of eating disorders or substance abuse can be prevented. Cachexia in the context of serious illnesses, on the other hand, cannot be directly avoided.
For cachexia, follow-up care primarily consists of achieving and maintaining a healthy body weight. Since the treatment of cachexia also consists in correcting the emaciated state of nutrition, the follow-up care should be based on the fact that the body weight remains stable and does not drop again in the meantime.
In aftercare, it is important to continue to eat enough food. High-calorie food is best suited here, in some cases high-calorie liquid food can also be drunk as a supplement or as a substitute. In any case, the optimal nutrient supply and reaching and maintaining a normal weight should be aimed for.
Because cachexia often occurs as a sequel to another underlying condition and rarely occurs in isolation, it is important to diagnose and treat this underlying condition. Therefore, it requires a thorough medical examination for all possible causes. In addition, follow-up care should consist of regularly checking the weight and examining the blood for defects. Since cachexia also leads to a decrease in muscles, it can make sense to slowly build muscle again with the help of sport.
Last but not least, it should also be considered that psychological counseling may be considered, because cachexia patients often also suffer psychologically from their external appearance. The severely emaciated body can be distressing and even lead to depression.
You can do that yourself
The disorder is life-threatening and must be treated by a doctor. Cachexia is usually due to a serious underlying disease, such as cancer, which is at a very advanced stage. In these cases, the patient himself can do little to improve his condition. Artificial nutrition is then very often required.
However, there is room for self-help measures where the cachexia is due to malnutrition or malnutrition. People suffering from anorexia or bulimia are particularly at risk. Since those affected usually have a severely disturbed self-image due to the disease and cannot or do not want to recognize the external signs of cachexia, it is up to the social immediate field to take the necessary measures to help themselves. Affected people who suffer from an eating disorder often try to hide it. Heavy weight loss is then caused by supposedly healthy activities such as a lot of sport or fastingexplained. In the event of sustained severe weight loss, the families of those affected should prick up their ears and sensitively but consistently insist that the person concerned seek medical treatment.
There are special counseling centers for the parents of children and young people suffering from anorexia and bulimia, which inform family members and support them in taking the measures that are indicated if a serious nutritional disorder is suspected.