Cachexia: Causes

Pathogenesis (development of disease)

A person’s normal energy requirements are composed of resting metabolic rate, consumption during physical activity, and thermogenesis. In cachexia, metabolism is shifted from the anabolic (building up) to the catabolic (breaking down) side; accordingly, there is not only a complete depletion of storage fat depots but also a generalized atrophy (“emaciation”) with a gradual loss of organ function. The cause in tumor patients may be a combination of inflammatory mediators and/or hormone-like substances that interact between the tumor and the body to cause this extreme loss of energy in the end organs.

Etiology (Causes)

Behavioral causes

  • Pleasure food consumption
    • Alcohol abuse
  • Drug use

Causes related to disease

  • Acute trauma – such as an accident or burns.
  • Anorexia nervosa (anorexia nervosa)
  • Chronic alcoholism
  • Chronic hepatitis (inflammation of the liver)
  • Chronic infections of any kind
  • Chronic organ failure – limitation in function such as heart failure (cardiac insufficiency); renal failure (renal insufficiency).
  • Ulcerative colitischronic inflammatory bowel disease.
  • Chronic obstructive pulmonary disease (COPD)
  • Intestinal ischemia – reduced blood flow to the intestine.
  • Dementia
  • Depression
  • Diabetes mellitus type 1
  • Diarrhea (diarrhea)
  • Drug addiction
  • Enteritis (inflammation of the intestine)
  • Final stage of incurable diseases
  • Low production of growth hormone
  • Heart failure (cardiac insufficiency) → cardiac cachexia (independent risk factor for premature death).
  • Hyperthyroidism (hyperthyroidism).
  • Cancers
  • Collagenoses (group of connective tissue diseases caused by autoimmune processes) – systemic lupus erythematosus (SLE), polymyositis (PM) or dermatomyositis (DM), Sjögren’s syndrome (Sj), scleroderma (SSc) and Sharp syndrome (“mixed connective tissue disease”, MCTD).
  • Liver failure
  • Malassimilation (disturbance of pre-digestion in the stomach, enzymatic breakdown of food components (exocrine pancreatic insufficiency / disease of the pancreas associated with insufficient production of enzymes), fat emulsification (eg, bile acid deficiency in cholestasis / biliary obstruction) and absorption or removal of absorbed food) – in gastrointestinal diseases.
  • Crohn’s diseasechronic inflammatory bowel disease.
  • Cystic Fibrosis (ZF) – genetic disease with autosomal recessive inheritance, characterized by the production of secretions in various organs to be tamed.
  • Esophageal stenosis – narrowing of the esophagus.
  • Pancreatic insufficiency – decreased ability of the pancreas to produce digestive juices.
  • Pancreatitis (inflammation of the pancreas).
  • Paranoia – mental illness
  • Rheumatoid arthritis (rheumatoid cachexia)
  • Pain
  • Sepsis (blood poisoning)
  • Tuberculosis – infectious disease affecting mainly the lungs.
  • Nausea / vomiting
  • Celiac disease (gluten-induced enteropathy) – chronic disease of the small intestinal mucosa (lining of the small intestine) due to hypersensitivity to the cereal protein gluten.

Medication

  • Cytostatics (substances that inhibit cell growth or cell division).

X-rays

Operations

  • Short bowel syndrome after bowel resection – removal of a section of bowel.
  • After major surgery as a stress reaction
  • After gastric resection (stomach removal).