Doctor, I have no appetite since last 2 weeks

Do your have fever? Did you have fever 2 weeks back? “No” (all fevers are followed by anorexia)

Are you taking any medicines regularly? “No”. (Biguanides, digitalis, antibiotics, anti-malarias etc. can cause anorexia)

Are you addicted to Paan-masala, Gutkha, Tobacco or alcohol? “No”

Do you have cough, expectoration, or low grade fever? “No”

Look at the sclera for icterus. Examine tongue, for pallor & apthous ulcers. (Anemia is a very common cause)

If anemic, “Do you get limb pains?”

“Do you feel breathless on exertion?”

Palate the abdomen carefully, for spleen and liver.

(Hepato/Splenomegaly will suggest systemic illness)

Palpate for epigastric lump to rule out carcinoma of stomach & liver.

Auscultate the chest carefully for Tuberculosis, effusion etc.

Key points for Anorexia: Pallor, Jaundice, any fever, ca-stomach, Tuberculosis, Addictions, side effects of drugs.

Action :

If no pathology is detected,

Give injection Bcomplex, apetising tonics, Protein rich diets.

Antehelminthics, antacids, cyproheptidine.

I.V. fluids & 25% glucose if anorexia is severe.