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Gepubliceerd in:
2016 | OriginalPaper | Hoofdstuk
3. Gewichtsverlies
Auteurs : H. de Vries, J. F. Bastiaans, F. J. van Ittersum
Gepubliceerd in: Diagnostiek van alledaagse klachten
Uitgeverij: Bohn Stafleu van Loghum
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Samenvatting
Onbedoeld gewichtsverlies wordt veelal als pathologisch beschouwd indien het meer dan 5 % van het uitgangsgewicht betreft, ontstaan in 6 maanden of kortere tijd. De oorzaken variëren van ernstige organische aandoeningen (bijvoorbeeld maligniteiten, infecties, endocriene afwijkingen, malabsorptiesyndromen) tot psychiatrische stoornissen. Depressie wordt het vaakst gevonden als oorzaak bij ouderen in de huisartsenpraktijk. Soms wordt een anorexia nervosa vastgesteld. Er zijn bijzonder weinig onderzoeksgegevens beschikbaar over de diagnostiek in eerstelijnspopulaties. Vanwege de brede differentiële diagnose bij gewichtsverlies dient de diagnostiek te worden gebaseerd op bijkomende bevindingen bij anamnese en lichamelijk onderzoek. In een aantal gevallen kan het gewichtsverlies aan een reeds bekende aandoening worden toegeschreven. Een systematische anamnese gericht op de factoren die van invloed zijn op het lichaamsgewicht (inname, opname, verbruik, verlies) levert de belangrijkste bijdrage aan de diagnostiek. Er zijn aanwijzingen dat een algeheel lichamelijk onderzoek zinvol is. De meeste auteurs bevelen verder screenend bloed- en urineonderzoek aan. Wat aanvullend onderzoek betreft, zijn er argumenten om bij ouderen een X-thorax aan te vragen. Verdergaand specialistisch onderzoek dat zonder aanwijzingen uit de anamnese of het lichamelijk onderzoek wordt gedaan, wordt niet zinvol geacht, zodat een afwachtend beleid gevoerd kan worden indien de hier genoemde onderzoeken geen afwijkingen opleverden. Daarbij is herbeoordeling na 6 maanden aangewezen. Aan specifieke oorzaken van gewichtsverlies bij ouderen (onder andere onvoldoende zorg, dementie, slikproblemen, maligniteiten, ernstige orgaandisfunctie en medicatie) dient aandacht besteed te worden.
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Metagegevens
- Titel
- Gewichtsverlies
- Auteurs
-
H. de Vries
J. F. Bastiaans
F. J. van Ittersum
- Copyright
- 2016
- Uitgeverij
- Bohn Stafleu van Loghum
- Boek
-
Diagnostiek van alledaagse klachten
Print ISBN: 978-90-368-1154-5
Elektronisch ISBN: 978-90-368-1274-0
Copyright: 2016
- DOI
- https://doi.org/10.1007/978-90-368-1274-0_3