Poor appetite Assessment Questionnaire

Why: to determine if acute or chronic. Acute poor appetite would most likely be due to an acute febrile disease or acute psychiatric illness.

Why: questions specifically about relationship, family, children, social support, occupation, general physical health and financial stresses. Emotional stress may lead to either under eating or over eating.

Why: e.g. severe loss, such as the death of a loved one, marital separation or financial loss. Emotional upset, grief, loss and relationship problems may cause poor appetite and under eating.

Why: e.g. diabetes; risk factors for liver cancer include carriers of hepatitis B and C, alcoholic cirrhosis and hemochromatosis; Hypothyroidism may be associated with previous Graves disease, Rheumatoid arthritis, Down Syndrome, previous radioactive ablation of the thyroid.

Why: e.g. gastric surgery may be complicated by chronic delayed gastric emptying, early fullness after eating and poor appetite.

Why: many mental illnesses may cause poor appetite and cause people to lose interest in eating including depression, anxiety, bipolar affective disorder, anorexia nervosa, bulimia nervosa.

Why: e.g. many medications may cause poor appetite including appetite suppressants, non-steroidal anti-inflammatory medications, erythromycin, digoxin, phenylpropanolamine, codeine, morphine, Demerol and aspirin; hypothyroidism may be caused by lithium or amiodarone.

Why: e.g. amphetamines will suppress the appetite.

Why: e.g. ovarian cancer, thyroid disease, depression.

Why: Alcoholic people frequently have a loss of appetite. Alcohol in high concentrations may cause gastritis.

Why: Weight loss usually accompanies poor appetite if the reduction in appetite is prolonged. Significant weight loss may suggest stomach cancer, intestinal or mesenteric ischemia, chronic pancreatitis, chronic gastritis, renal failure and congestive heart failure.

Why: Any fever may cause a temporary loss of appetite. A prolonged fever may affect appetite long enough to cause weight loss. A fever may suggest a localized abdominal condition (e.g. cholecystitis, acute appendicitis) or a systemic condition (e.g. tuberculosis, brucellosis, yellow fever).

Why: Most causes of painful swallowing will also cause difficulty with swallowing. Painful swallowing can lead to people and especially children to try not to eat. If painful swallowing is present without any real difficulty with swallowing must consider Candida infection, herpes simplex infection or medication induced ulceration of the esophagus (e.g. from emepronium or slow release potassium tablets that may lodge in the gullet when swallowed lying down or without water).

Why: suggests esophageal cancer until proven otherwise.

Why: consider achalasia, scleroderma or diffuse esophageal spasm.

Why: should consider a diagnosis of reflux oesophagitis with or without a hiatus hernia, peptic ulcer, achalasia, diffuse esophageal spasm or advanced esophageal cancer.

Why: must consider acute cholecystitis (inflammation of the gallbladder usually due to obstruction from a gallstone), peptic ulcer, acute appendicitis, pyelonephritis (bacterial infection of the kidney), pancreatitis, renal stones and peritonitis.

Why: may suggest pancreatic cancer, liver metastases, cancer of the bile ducts.

Why: may suggest tuberculosis or lung cancer.

Why: may suggest gastroenteritis, Crohn's disease.

Why: e.g. early feeling of fullness after eating, indigestion, loss of appetite, weight loss, vomiting (if cancer causes stomach outlet obstruction), difficulty with swallowing ( if cancer occurs at opening to stomach).

Why: e.g. frequency of urination, excessive thirst, weight loss, fatigue, increased infections. May be complicated by gastroparesis which causes delayed emptying of the stomach, a feeling of fullness and poor appetite.

Why: e.g. symptoms at presentation are usually nonspecific and usually include abdominal pain, increasing abdominal girth and abnormal menstrual bleeding. Ovarian cancer may also cause reduced appetite and an early feeling of fullness after eating due to pressure on the stomach.

Why: e.g. weight loss, reduced appetite, fever, ache over the right upper abdomen, abdominal swelling and an early feeling of fullness after eating.

Why: e.g. gradual onset of severe constant right upper abdominal pain which may pass into the back. It can be associated with reduced appetite, nausea and vomiting. Symptoms are induced by a fatty meal.

Why: e.g. reduced appetite, nausea, vomiting, fever, diarrhea.

Why: e.g. indigestion, vomiting, sometimes coffee ground vomit and melena (black tarry offensive stools) due to gastrointestinal bleeding. Gastritis may also cause poor appetite and an early feeling of fullness after eating.

Why: e.g. intermittent difficulty with swallowing both solids and liquids; regurgitation of food into mouth from the esophagus may occur, particularly at night; occasionally food may get stuck; drinking large quantities of fluids help force the food through if food gets stuck; severe pain behind the breastbone due to dysfunctional contraction of the esophagus; weight loss may occur but is usually not marked. May also have poor appetite and a feeling of fullness after eating.

Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), increase or decrease in appetite (usually decreased), weight loss or gain, insomnia or increased sleeping (usually early morning waking), fatigue, loss of energy, feelings of worthlessness, feelings of excessive guilt, poor concentration, difficulty making decisions, low libido, thoughts of death or suicide attempt.

Why: e.g. nervousness, shakiness, tremor, restlessness, irritability, insomnia, poor concentration, heart palpitations, racing heart, sweating, dizziness, diarrhea, lump in throat, reduced appetite and frequency of urination.

Why: e.g. episodes of depression (often psychotic in intensity) and at other times episodes of psychotic excitement (mania or hypomania). Symptoms of psychotic excitement may include elevation of mood, increased activity, grandiose ideas, irritability, disinhibition (which affects social, sexual and financial behavior), rapid speech and racing thought, delusions (persecutory or grandiose) and sometimes hallucinations. May sometimes have poor appetite.

Why: e.g. headache, dementia, seizures, stroke-like symptoms.

Why: e.g. progressive difficulty with swallowing; initially there is difficulty with swallowing solids, but eventually difficulty with swallowing liquids also occurs. Pain occurs if food gets stuck due to narrowing of the esophageal lumen. Weight loss occurs due to difficulty with swallowing and also due to reduced appetite.

Why: e.g. intermittent difficulty with swallowing both solids and liquids; regurgitation of food into mouth from the esophagus may occur, particularly at night; occasionally food may get stuck; drinking large quantities of fluids help force the food through if food gets stuck; severe pain behind the breastbone due to dysfunctional contraction of the esophagus; weight loss may occur but is usually not marked.

Why: e.g. lethargy, weight gain despite reduced appetite, constipation, puffiness of face and eyes, hair loss, dry skin.

Why: e.g. obsessive pursuit of thinness through dieting, extreme weight loss, disturbance of body image, intense fear of becoming fat, loss of menstrual periods.