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Query: UMLS:C0038187 (starvation)
 24,951 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anorexia nervosa and bulimia nervosa are both psychosocial pathological eating disorders. An intense preoccupation with food, weight and a distorted body image coupled with a morbid fear of becoming obese are common elements in both syndromes. Self-starvation with extreme weight loss is associated with anorexia nervosa. Bulimia nervosa is characterized by unrestrained eating sprees followed by purging, fasting or vomiting. Approximately 50% of anorexia nervosa patients also practice bulimia. The impact of eating disorders on the oral soft and hard tissues depends upon the diet as well as the duration and frequency of binge-purge behavior. Erosion of the teeth due to frequent regurgitation of highly acidic stomach contents is a common finding. Dental caries development is less predictable and appears to be diet- and oral hygiene-dependent. Painless enlargement of the parotid salivary glands is a common sequela of chronic vomiting but the pathophysiological cause has not been firmly established. The dehydration of the oral soft tissues due to salivary gland impairment in addition to dietary deficiencies and poor oral hygiene can adversely impact the health of the periodontal tissues and oral mucosa. Initial dental care is focused on discouraging behavior that is destructive to the oral tissues. Improved oral hygiene, the use of gastric acid-neutralizing antacid rinses and the daily application of topical fluorides can be useful in reducing enamel erosion. Extensive restorative oral rehabilitation should be postponed until the underlying psychiatric components of the disorder are stabilized.
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PMID:Dental aspects of anorexia and bulimia nervosa. 269 4

Although aspiration is a relatively rare event during anaesthesia, it represent an important cause of anaesthesia related mortality and also of ventilator associated pneumonia in intensive care unit. The incidence of aspiration is markedly increased after trauma owing to the risk of recent ingestion of food, depression of consciousness and airways reflexes, and gastric stasis induced by raised sympathoadrenal tone. The factors which contribute to the likelihood of aspiration include the urgency of surgery, airways problems, inadequate depth of anaesthetic, use of the lithotomy position, gastrointestinal problems, depressed consciousness, increased severity of illness and obesity. Factors that predispose to aspiration pneumonia are: a gastric content with a pH less than 2.5 and a gastric volume of 0.4 ml kg-1; a reduction in lower oesophageal sphincter tone; a reduction of upper oesophageal sphincter tone and a not coordination between the pharyngeal muscle and the upper oesophageal sphincter tone during swallowing; and a depression of protective airway reflexes. Methods to minimize regurgitation and aspiration involve control of gastric contents (preoperative starvation is the method universal accepted), application of cricoid pressure and control of the airways.
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PMID:Gastric reflux and pulmonary aspiration in anaesthesia. 1276 74

The time interval between ingestion and regurgitation and the stage of digestion in regurgitated food may be factors helpful in diagnosing disease of the esophagus. In most cases diagnosis can be made by x-ray alone, but where x-ray evidence is insufficient esophagoscopy is often justified.X-ray investigation for foreign bodies should include films of the neck. Cough is a common symptom of the presence of foreign bodies; obstruction may result from inflammation or edema. Perforation is most often caused by foreign bodies or by instrumentation. Esophagoscopy is hazardous in this condition and the findings are not likely to affect the course of treatment. Hiatal hernia, although probably occurring to some degree in 10 per cent of adults, seldom causes symptoms. Inflammation resulting from hernial obstruction may be mistaken for carcinoma. Esophageal carcinoma occurs most frequently in elderly persons and in men more than in women. Operation is necessary in many cases to prevent starvation. The postoperative mortality rate is as low as 11 to 24 per cent, and the proportion of five-year survivals is increasing. Achalasia or cardiospasm can generally be recognized by x-ray appearance. Bouginage is the usual treatment, but operation may be necessary. Late regurgitation of food is a common symptom of esophageal diverticulum. Atresia in a newborn infant is a dangerous condition. The effect of any of the four types of anomaly is the same: diversion of fluids from the stomach to the bronchi. Coughing, choking and cyanosis are the common symptoms in a newborn infant. Hematemesis may arise from a number of causes; esophageal hemorrhage most commonly is owing to varicosity from portal hypertension. Esophagoscopy is the quickest and safest method of determining whether hematemesis is of esophageal origin.
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PMID:Differential diagnosis of operable disease of the esophagus. 1305 38