Atrophy is a reduction in the size of a tissue or organ. The cells of the affected area lose volume and mass. This can have both physiologic and pathologic causes.
What is atrophy?
Atrophy is tissue loss caused by a decrease in the number of cells in tissues and organs. This results in a partial or complete reduction in the size of the affected tissue, or organ. This is possible due to apoptosis, or programmed cell death. The actual shape of the affected area may be preserved or altered in atrophy. Causes of atrophy may include poor nutrition, mutations, poor blood supply, severely reduced nerve supply, disuse of muscles, or excessive cell death. Atrophy can be physiological and pathological, and can affect the entire system or occur in a limited fashion. Physiologically, it occurs in the human growth process and allows the necessary changes in the organisms. Unlike pathological atrophy, this tissue atrophy is necessary and an important function of growth. To some extent, pathological tissue atrophy is reversible, that is, it is reversible to the normal size.
Causes
Atrophy has many different causes, which can be physiological or pathological. The pathological form results from an imbalance between the buildup and breakdown of structure. Aging atrophy has genetic causes and the moment of onset depends on the patient’s age and organ disposition. Some organs have fulfilled their usefulness early and are degraded early. This atrophy is called involution. The thymus becomes atrophied after acquiring sexual maturity and is replaced by adipose tissue. The bone marrow also changes during life. In infancy, there is hematopoietic parenchyma, or red marrow, throughout the medullary cavity. With age, the red marrow atrophies in most places and is also replaced by fatty tissue. Tissue atrophy in the ovaries initiates menopause in the female sex. Sperm production in males is also reduced, but remains partially intact. Starvation atrophy causes a decrease in general adipose tissue, skeletal and cardiac muscles, and internal organs. In this case, atrophy allows energy to be supplied during a greatly reduced food intake. An unused muscle also atrophies, which is predominantly the case in bedridden elderly patients. This is referred to as inactivity atrophy. A severe reduction in blood and nerve supply can also lead to cell death after a period of time and is called energy deficiency atrophy. Pressure atrophy is caused by chronic pressure on organs or bones. In the brain, certain forms of atrophy can develop with increasing age and cause diseases such as Parkinson’s, dementia and Alzheimer’s disease due to structural degradation.
Symptoms, signs, and complaints
The symptoms and complaints of atrophy depend on the organ affected. Muscle atrophy is characterized by a reduction in the size of one of the extremities. This causes difficulty walking and maintaining balance. The affected area is dizzy, swollen and tingling. The face is weakened and there is difficulty eating and speaking. The patient feels fatigue throughout the body. In the worst case, the muscle area is paralyzed. Atrophy of the ovaries initiates menopause. The first symptoms of this are sleep disturbances, cycle fluctuations and mood swings. Estrogen hormones decrease and stress hormones increase. Many women complain of a feeling of tightness and pulling in the breasts just before menstruation. Eventually, menstruation stops completely. Organ atrophy results in a loss or decrease in the function of these. In optic atrophy, the optic nerve is severely damaged. This causes a decrease in vision or even blindness.
Diagnosis and progression
Because atrophy can affect any tissue or organ, the diagnosis and course of the disease vary. A reduction in cell number and size can be detected microscopically. To some degree, atrophy is reversible.
Complications
In pathologically induced atrophy, an imbalance occurs between the buildup and breakdown of cell structures, leading to various complications and health disorders. This reduction in cell number and cell size can affect any organ in the body. Ovarian atrophy is uncomplicated, heralding menopause with symptoms such as sleep disturbances, feelings of tightness in the breasts, and mood swings until menstruation eventually stops altogether. Men often suffer from atrophy of the testicles. Brain atrophy, on the other hand, is complicated and cannot be cured, but can only be slowed down by individual therapeutic approaches. Dementia, Alzheimer’s disease and Parkinson’s disease can occur as a result. In the worst case, muscular atrophy leads to difficulties in movement and coordination. The affected muscle areas show signs of paralysis and sensory disturbances, it is difficult to eat and speak, and the patient feels signs of fatigue. Depending on the severity of the complications that occur, muscle atrophy can be treated with exercise therapy and medications that improve circulation. Aging atrophy is a genetic tissue breakdown that depends on the patient’s age and organ disposition. In growing individuals, some organ and cell structures have prematurely fulfilled their usefulness. Therefore, early atrophy occurs, which is called involution. The degraded structures are replaced by adipose tissue. The bone marrow is also affected by this genetic process with increasing age. Since senile atrophy is a natural process, treatment is not necessary.
When should you see a doctor?
If atrophy is suspected, the patient should talk to his or her primary care physician promptly. Depending on the type and severity of atrophy, several warning signs indicate a severe progression. If difficulty walking and maintaining balance occur, muscle atrophy may be present. A physician must be consulted immediately. The physician can determine the atrophy by microscopic examination and, if necessary, initiate treatment directly. A visit to the doctor is particularly urgent if swelling and pain are added to the symptoms mentioned or if the affected area suddenly becomes numb or very sensitive to touch. At the latest, if difficulties in eating and speaking as well as general signs of fatigue are added, a doctor must be consulted with muscle atrophy. If ovarian atrophy is suspected, a visit to the gynecologist is advisable. Typical symptoms such as sleep disturbances, mood swings and menstrual cramps should also be clarified independently of atrophy. A decrease in visual acuity or even blindness indicates optic atrophy, which must be treated immediately.
Treatment and therapy
Not all atrophy can be treated. In some cases, it can only be slowed down as in the case of cerebral atrophy. Depending on the form and cause of the atrophy, further tissue loss must be prevented and metabolism stimulated. To prevent further muscle and joint loss, the affected area must be treated with physiotherapy. Exercise therapy, positioning and cooling help in this process. In drug therapy, painkillers can be used or blood-promoting drugs. Often, decreased blood flow is the cause of atrophy. If orthostatic hypotension is the cause of decreased blood flow, support stockings and increased water-salt intake may be effective. Parkinson’s disease can be treated with dopaminergics, which inhibit dopamine degradation. In this case, the progression of the disease is slowed. A cure is not yet possible. In starvation atrophy, many parts of the body are usually affected. In this case, a lengthy therapy is ahead. The food intake must be increased and the metabolic balance restored.
Outlook and prognosis
The prognostic prospects of atrophy are individual and depend on the cause present. Overall, however, they are considered less favorable. In the worst case, the progress of tissue atrophy cannot be stopped with current medical options. It progresses inexorably until the tissue has completely disappeared. This depends on the affected region and the damaged tissue.Consequential symptoms and further impairments in lifestyle occur. In some forms of the disease, the goal of treatment is to delay the progress of tissue deterioration as long as possible. Parallel therapies are offered with targeted training to maintain certain physical functional capabilities. Medication is used to alleviate the side effects and additional symptoms of the disease in order to improve the patient’s quality of life. A cure or complete recovery is not expected for atrophy. At present, according to the current state of scientific and medical knowledge, there are no adequate options for curing the causes of atrophy. If therapy is fundamentally rejected, the health condition gradually worsens. Complaints increase and reduce the general well-being immensely. Often, it is no longer possible to cope with everyday life without assistance. With medical care, the patient can be guaranteed a prolongation of life, as the degradation process of the tissue is influenced.
Prevention
Genetically fixed atrophy cannot be prevented. In the physiological form, this is also not necessary. Pathological atrophy can be prevented by regular exercise, a healthy diet, and avoiding toxic substances and taking hormones. In bedridden patients, physiotherapeutic measures are inevitable. In addition, a balanced diet provides an equitable supply of energy to all organs.
Aftercare
Atrophy involves the reduction in size of a tissue or organ. There is often no cure for this condition. Genetic causes in particular result in an unfavorable prognosis. Therefore, follow-up care cannot aim to prevent recurrence of the disease. Rather, the aim is to support the patient in everyday life and to stop complications. It is important to slow down the progression. Doctors usually prescribe physiotherapies for this purpose. They stimulate the metabolism and inhibit degradation in certain regions of the body by means of suitable exercises. However, depending on the cause, medications can also hinder the progression of the disease. The primary goal is to stop tissue deterioration. In the advanced stage, patients often need help in everyday life. It is almost impossible to carry out a profession. Complications occur mainly if therapies are not taken up. Atrophy entails regular visits to the doctor. Patients can take action themselves to stop atrophy that is not genetically caused. Preventive measures such as regular exercise and a varied diet are important. Alcohol and nicotine should be avoided. The body does not build up immunity after a single infection. A mostly hereditary disease is possible in different parts of the body.
What you can do yourself
Since atrophy can have many causes, which include the lifestyle of the affected person or pathological causes, self-help measures are only partially effective. For example, there are no significant options that sufferers of genetic atrophy can take. Even in the case of very advanced atrophy, in which much tissue has already been lost, measures are limited to slowing the breakdown of the remaining tissue. However, atrophy can often still be slowed down or even reversed if those affected adjust their diet. The supply of nutrients must be significantly increased, and the metabolism must be activated in such a way that it works efficiently. Thus, a balanced diet must be composed, which at the same time brings more nutrients (and calories) than are needed. Lack of blood circulation can also promote atrophy. Massages, exercise and avoiding substances that damage blood vessels can help. These include alcohol and trans fats. Light exercise should be pushed, taking care to spare the joints and muscles. Little-used muscles and joints that are particularly affected by atrophy should still be exercised and massaged, which means continuing physiotherapeutic measures by the sufferers themselves.
