Symptom finder - The causes of thirst
Symptom finder - The causes of thirst
Thirst is caused by drugs ( ecstasy and overdose of diuretics), psychiatric disorder ( psychogenic polydipsia), inadequate intake of fluid ( anorexia, neurological disorder and general debility) , diet ( spicy foods and salty foods), association with dry mouth ( post neck and head radiotherapy , drugs such as monoamine oxidase inhibitor or anticholinergic and Sjorgen syndrome), endocrine and metabolic disorders ( chronic renal failure, cranial/nephrogenic diabetes insipidus and diabetes mellitus) and excessive loss of fluid ( burns, excessive sweating, loss of blood which is sufficient enough to decrease the volume of blood , diarrhea, fever and vomiting).
Thirst is accurately defined as an association between two symptoms such as polyuria ( excessive urination) or polydipsia ( excessive amount of fluid intake).
A full history of lethargy, weight loss and tiredness are associated with diabetes mellitus. A drug history should focus on any intake of anticholinergic which is the drug which causes dry mouth. Dry mouth will lead to excessive intake of fluid (polydipsia) which later progress to polyuria. Psychological assessment is required in case of psychogenic polydipsia . It is important to notice any history of chronic blood loss. Sjorgen syndrome is suspected in patient with arthritis, dry eyes and dry mouth as well as swelling of the salivary gland. History of salty food and spicy food intake are also important. Focus on the onset of thirst. The thirst may be acute or chronic. Look for any evidence of nausea, vomiting or infection. Cranial diabetes insipidus may occur as a result of pineal gland tumors, craniopharyngioma, severe blunt head injuries and transient post operative complication following neurosurgery. Polyuria may occur due to nephrogenic diabetes insipidus or from intrinsic osmotic effect due to chronic hypercalcemia from hyperparathyroidism and malignancy. It is also important to differentiate between true thirst and dry mouth.
The patient’s temperature is observed . Observed for any signs of infection such as loss of skin turgor and dry coated tongue. Evidence of recent weight loss is also important. Any evidence of Sjorgen syndrome should be considered such as arthritis, dry eyes and enlargement of the submandibular gland, parotid gland as well as salivary gland.
The investigations require are full blood count, urinalysis, urea and electrolytes, blood sugar, serum calcium, parathyroid hormone, renal biopsy, ultrasounds, CT- scan/MRI scan, water deprivation test and DDAVP test.
Full blood count may reveal low Hb level due to loss of blood and raised white cell count due to infection as well as increase in PCV or packed cell volume due to dehydration. Urea and electrolytes are useful to rule out renal failure. Urinalysis is important in detecting an acute onset of diabetes. In this case sugar and ketone may be detected in the urine. Blood sugar will rise in case of diabetes. There will be an increase in serum calcium due to osmotic diuresis. Parathyroid hormone level will rise due to hypoparathyroidism. Renal biopsy may outrule renal failure.
Ultrasound is important to detect the present of renal failure. CT- scan/MRI scan is used to detect any tumor /cerebrovascular accident which may lead to cranial diabetes insipidus . DDAVP test may distinguish between cranial diabetes insipidus ( raised urine osmolality) or nephrogenic diabetes insipidus ( low urine osmolality). Water deprivation test is useful to detect the present of cranial diabetes insipidus.
Thirst is caused by drugs ( ecstasy and overdose of diuretics), psychiatric disorder ( psychogenic polydipsia), inadequate intake of fluid ( anorexia, neurological disorder and general debility) , diet ( spicy foods and salty foods), association with dry mouth ( post neck and head radiotherapy , drugs such as monoamine oxidase inhibitor or anticholinergic and Sjorgen syndrome), endocrine and metabolic disorders ( chronic renal failure, cranial/nephrogenic diabetes insipidus and diabetes mellitus) and excessive loss of fluid ( burns, excessive sweating, loss of blood which is sufficient enough to decrease the volume of blood , diarrhea, fever and vomiting).
Thirst is accurately defined as an association between two symptoms such as polyuria ( excessive urination) or polydipsia ( excessive amount of fluid intake).
A full history of lethargy, weight loss and tiredness are associated with diabetes mellitus. A drug history should focus on any intake of anticholinergic which is the drug which causes dry mouth. Dry mouth will lead to excessive intake of fluid (polydipsia) which later progress to polyuria. Psychological assessment is required in case of psychogenic polydipsia . It is important to notice any history of chronic blood loss. Sjorgen syndrome is suspected in patient with arthritis, dry eyes and dry mouth as well as swelling of the salivary gland. History of salty food and spicy food intake are also important. Focus on the onset of thirst. The thirst may be acute or chronic. Look for any evidence of nausea, vomiting or infection. Cranial diabetes insipidus may occur as a result of pineal gland tumors, craniopharyngioma, severe blunt head injuries and transient post operative complication following neurosurgery. Polyuria may occur due to nephrogenic diabetes insipidus or from intrinsic osmotic effect due to chronic hypercalcemia from hyperparathyroidism and malignancy. It is also important to differentiate between true thirst and dry mouth.
The patient’s temperature is observed . Observed for any signs of infection such as loss of skin turgor and dry coated tongue. Evidence of recent weight loss is also important. Any evidence of Sjorgen syndrome should be considered such as arthritis, dry eyes and enlargement of the submandibular gland, parotid gland as well as salivary gland.
The investigations require are full blood count, urinalysis, urea and electrolytes, blood sugar, serum calcium, parathyroid hormone, renal biopsy, ultrasounds, CT- scan/MRI scan, water deprivation test and DDAVP test.
Full blood count may reveal low Hb level due to loss of blood and raised white cell count due to infection as well as increase in PCV or packed cell volume due to dehydration. Urea and electrolytes are useful to rule out renal failure. Urinalysis is important in detecting an acute onset of diabetes. In this case sugar and ketone may be detected in the urine. Blood sugar will rise in case of diabetes. There will be an increase in serum calcium due to osmotic diuresis. Parathyroid hormone level will rise due to hypoparathyroidism. Renal biopsy may outrule renal failure.
Ultrasound is important to detect the present of renal failure. CT- scan/MRI scan is used to detect any tumor /cerebrovascular accident which may lead to cranial diabetes insipidus . DDAVP test may distinguish between cranial diabetes insipidus ( raised urine osmolality) or nephrogenic diabetes insipidus ( low urine osmolality). Water deprivation test is useful to detect the present of cranial diabetes insipidus.
