Symptoms and Signs – Differential Diagnosis of Polyphagia

Symptoms and Signs – Differential Diagnosis of Polyphagia
Polyphagia denotes voracious or excessive consumption of food. This prevalent symptom may be either persistent or intermittent, primarily arising from endocrine and psychiatric diseases, as well as the use of specific medications. Polyphagia may lead to weight increase, contingent upon the underlying cause.

Medical History and Physical Assessment
Commence your assessment by inquiring about the patient's dietary and fluid intake over the preceding 24 hours. If he readily remembers this information, inquire about his intake over the preceding two days to gain a comprehensive understanding of his food habits. Record the frequency of meals together with the quantity and varieties of food consumed. Determine whether the patient's dietary habits have lately altered. Has he consistently possessed a substantial appetite? Does his binging fluctuate with episodes of anorexia? Inquire about factors that may precipitate overeating, like stress, depression, or menstruation. Does the patient genuinely experience hunger, or does he consume food just due to its availability? Does he have vomiting or headaches subsequent to overeating? Investigate associated indications and symptoms. Has the patient had recent weight increase or loss? Is he experiencing fatigue, anxiety, or excitement? Has he encountered heat intolerance, dizziness, palpitations, diarrhea, or heightened thirst or urination? Acquire a comprehensive pharmacological history, encompassing the utilization of laxatives or enemas. Weigh the patient during the physical checkup. Inform him with his present weight and observe for any signs of disbelief or rage.

Examine the skin for signs of dryness or inadequate turgor. Examine the thyroid for hypertrophy.

Etiological Factors
Apprehension
Polyphagia may arise from mild to moderate worry or mental distress. Mild anxiety generally manifests as restlessness, insomnia, impatience, persistent questioning, and an incessant need for attention and reassurance. Moderate anxiety may also result in selective inattention and concentration difficulties. Additional manifestations of anxiety may encompass muscle tension, sweating, gastrointestinal trouble, palpitations, tachycardia, and disruption in urine and sexual functions.

Bulimia nervosa
Bulimia, predominantly observed in women aged 18 to 29, is characterized by episodes of polyphagia interspersed by self-induced vomiting, fasting, or diarrhea. The patient generally exhibits a weight below the normative range, however harbors an intense fear of fat. She exhibits signs of depression, possesses low self-esteem, and hides her overeating behavior.

Diabetes mellitus
Diabetes mellitus is characterized by polyphagia accompanied by weight loss, polydipsia, and polyuria. It is associated with nocturia, weakness, weariness, and indicators of dehydration, including dry mucous membranes and diminished skin turgor.

Premenstrual syndrome (PMS)
Alterations in appetite, characterized by food cravings and binge eating, are prevalent during PMS. Abdominal bloating, the most prevalent related symptom, may manifest alongside behavioral alterations, including sadness and sleeplessness. Headache, paresthesia, and further neurological symptoms may also manifest. Associated findings encompass diarrhea or constipation, edema, transient weight gain, palpitations, back pain, breast swelling and tenderness, oliguria, and increased susceptibility to bruising.

Alternative Causes
Pharmaceutical substances
Corticosteroids, cyproheptadine, and some hormone supplements may enhance hunger, resulting in weight gain.

Provide the patient experiencing polyphagia with emotional support and assist him in comprehending its underlying cause. Refer him and his family for psychological counseling as necessary. Refer the patient for dietary advice and for individual and family counseling. Offer emotional support and assist the patient in comprehending the disease process. In children, polyphagia frequently arises from juvenile diabetes. In infants aged 6 to 18 months, it may arise from a malabsorptive illness, such as celiac disease. Polyphagia may develop normally in a youngster undergoing a fast growth spurt.