Recent onset hyporexia

Specialty: General.

• moderate loss of appetite
• reluctance to eat
• recent decreased appetite
• partial refusal of food

Why it occurs

• Acute or subacute infectious diseases (such as lobar pneumonia, tuberculosis, deep dental abscesses or non-oligosymptomatic pyelonephritis)
• Acute organic gastrointestinal disorders (erosive gastritis, chronic stone cholecystitis, chronic pancreatitis or inflammatory bowel disease)
• Initiation of new commonly consumed drugs (metformin, digoxin at borderline levels, selective serotonin reuptake inhibitors, chemotherapy or antibiotics)
• Reactive psychopathological disorders (grief, reactive major depression or acute adjustment disorders)
• Chronic kidney disease or chronic liver disease that is stable but in a phase of subclinical metabolic decompensation.

Initial workup

Complete blood count, erythrocyte sedimentation rate, detailed liver profile, urea nitrogen, creatinine, serum electrolytes, general urine examination, and ultrasound of the upper abdomen or upper gastrointestinal endoscopy as suspected.

Standard management

• Metoclopramide — 10 mg orally 30 minutes before meals to stimulate gastric motility and emptying
• Vitamin complex with Zinc — Zinc in doses of 15 to 30 mg per day can help restore taste acuity and appetite in patients with marginal deficiencies
• Dietary modification with fractionated meals of high caloric density and reduced volume.