1. Hello doctor, I am suffering from loss of appetite. I can even go for three days without thinking about food. What would be the problem? Please advise- Desire
Dear Desire:
This is a tricky question because although food that is consumed is more guided by appetite (desire) than by hunger (need), many think by not being hungry, they luck appetite. It is therefore important to begin by ascertaining whether your symptom is luck of appetite or not feeling hungry.
Hunger vs appetite
Hunger comes on slowly and is the result of a physiological need to eat, it is triggered by the mechanical stimuli of the stomach being empty, and your body seeks to reduce the sensation of an empty stomach by consuming needed fuel. This sensation triggers stomach cells to release a hormone called ghrelin which stimulates the nerve which runs between the stomach and brain called the vagus nerve.
The hormone ghrelin stimulates an area of the brain that controls hanger called the hypothalamus which initiates food-seeking behaviors.
Hunger is also accompanied by a lack of energy and enthusiasm (lethargy) and a growling stomach. Therefore, any condition affecting either stomach cells, the vegas nerve or the hypothalamus may present with a luck of feeling hungry. For example, any inflammation in the stomach (gastritis), wounds (ulcers), cancers, injury (damage to any of the three) and an infection may cause this luck of hunger.
On the other hand, appetite comes on suddenly and is driven by the brain’s desire to eat a specific thing, implying that an individual who has an appetite may suddenly want to eat a specific food even if they are not hungry.
It is usually, for a specific kind of food and gives less of a feeling of satisfaction. It is driven by an emotional or mental desire, and the brain will use appetite to guide the body to eat certain nutrients it may be lacking, by causing craving. For instance, the desire to have high-protein meal after a workout, and losing the desire to eat certain soup if the brain senses the soup has a fly in it.
Need for investigation
Loss of appetite whether alone or in association with other signs like loss of weight, may indicate an infection like Tuberculosis (TB) or certain cancers especially gastral intestinal cancers. This always warrants investigation to be ruled out or confirmed. Anything that may stress our emotions centers may affect our desire for food as well.
2. Hello Doctor, is it in order to drink alcohol while pregnant? How does alcohol affect pregnancy? – Jean
Dear Jean,
Depending on the dose, duration and developmental stage of the embryo at exposure, taking alcohol in the days preceding and during pregnancy may have harmful effects on the brain, spinal chord and other organs of the developing baby.
Dose and frequency
At high repetitive doses, there is a 6–10 per cent risk of the fetus developing before birth occurs (prenatal) and postnatal after birth (postnatal) growth deficiency, specific flaws in appearance involving the skull and the face (dysmorphic features), mental retardation, behavioral changes and a variety of major anomalies (the fetal alcoholic syndrome).
Whereas at lower repetitive doses, there is a risk for slight intellectual impairment, growth disturbances and behavioral changes.
Binge drinking
Even binge drinking which is defined as four or more alcoholic drinks for females on the same occasion, may impose some danger of slight intellectual deficiency.
Effects on the future life of the child
A research done in Dublin, Ireland at Mater University in 2008 found out that increased risk of alcohol consumption among adolescents 14 years old was found in those whose mothers reported alcohol consumption before, during and after pregnancy. There was an increased risk of early alcohol initiation among the ones exposed to greater alcohol use during pregnancy.
How the child drinks
Alcohol as a drug crosses the placenta, implying that when you drink alcohol in pregnancy, your unborn child also drinks.
What alcohol actually does
Increasing doses of alcohol lead to excessive production of an influencer of various enzymes and processes (NADH) common and vital to some of the basic functions of life, including respiration (redox reactions), with a concomitant decrease in the formation of glucose leading to lower sugar levels in the blood (hypoglycemia). These reduced sugar levels among other toxic by product of alcohol procession (acetaldehyde) have an effect on the child’s developing brain and other organs leading to intra uterine growth restrictions.
Answered by Dr Molino,
Resident Doctor at German Medical Center Machakos.
