27 Nov Alterations in Cellular Processes
The role genetics plays in the disease
Genetically there is a predisposition to some malabsorption syndromes, but may not apply to this particular patient. Malabsorption syndromes can therefore be due to genetic disorders like celiac disease, cystic fibrosis or enzyme deficiencies. However, in elderly patients, protein malabsorption may be attributed to other factors like age related changes in GI tract, systemic diseases, or as may be evident in the present case mechanical problems like inability to chew food due to lack of dentures (Norman et al., 2021). Thus, although there might be a genetic predisposition to malabsorption in this case it is completely overshadowed by the patient’s young age and lack of dental care resulting in poor nutrition.
Why the patient is presenting with the specific symptoms described
The patient complains of generalized edema in the extremities and the abdomen, which are symptoms of severe protein deficiency. It results from the fact that proteins, especially albumin, have an important function of regulating oncotic pressure within blood vessels. If there is a lack of proteins then the liquid starts to flow out of the vessels into the surrounding tissues thus leading to swelling. This condition, called hypoalbuminemia, results in low oncotic pressure and causes the retention of fluids in tissues leading to generalized edema (Vidales & Montoro-Huguet, 2022). Moreover, the past history of malabsorption syndrome worsens this condition, as it affects the patient’s ability to absorb nutrients, including proteins, leading to severe edema.
The physiologic response to the stimulus presented in the scenario and why you think this response occurred
There are several ways through which the body physiologically responds to the stimulus of protein deficiency. Initially, the body acts by using the muscle mass to release amino acids to support essential processes like the formation of enzymes and immune function. However, this results in muscle atrophy and enhanced weakness (Norman et al., 2021). The liver tries to synthesize albumin and other proteins when dietary intake fails to suffice the body’s needs, yet the liver becomes strained. Therefore, hypoalbuminemia results in low oncotic pressure and associated edema. Also, due to the impairment of the gastrointestinal tract absorption, nutrient intake is also affected hence increasing the effects of the deficiency on the body.
The cells that are involved in this process
Some of the cells that are involved in this process are hepatocytes, enterocytes, and myocytes. Hepatocytes are involved in the production of plasma proteins such as albumin. Malnutrition affects the liver’s hepatocytes as the substandard substrates diminish its function hence resulting in low albumin levels (Serón-Arbeloa et al., 2022). Malabsorption syndrome affects enterocytes, making nutrient and protein absorption low, worsening the deficiency. Myocytes which is muscle cells are subject to catabolism when the body tries to feed on muscles to meet metabolic demands thus leading to muscle atrophy and decline in muscle strength.
How another characteristic (e.g., gender, genetics) would change your response
Another variable that would affect the response to protein malnutrition is age. This is especially true for elderly patients, such as the 83-year-old in this case, due to several reasons. Inflammations of the digestive system that affect the elderly include reduced secretion of the gastric acid and slow movement of the colon. In addition, elderly patients may present with polypharmacy, chronic diseases and medications that might affect the intake and assimilation of nutrient (Vidales & Montoro-Huguet, 2022). Further, social factors, including inadequate access to healthy food and cumbersome tasks of cooking, also increase the possibility of malnutrition in the elderly.
On the other hand, a young person with the same ailment may develop an entirely unique body response. This is the reason why it is easier to recover from malnutrition among the young population because they have high metabolic rates and efficient nutrient assimilation. They are more muscular and have better adapted physiques to the survival of scarce nutrient intakes to reduce the effects of symptoms such as oedema (Serón-Arbeloa et al., 2022). Nonetheless, any level of chronic malnutrition can cause serious, long-term health implications, such as growth impairment, a compromised immune system, and vulnerability to illness.
Conclusion
The 83-year-old patient suffers from protein malnutrition due to malabsorption syndrome and dysphagia because of missing dentures, leading to generalized edema and other severe manifestations. The physiological response is a multi-organ, multi-cellular phenomenon, indicating the complexity of this condition. Age plays a crucial role in determining the severity of malnutrition and the patients’ ability to respond to it; the elderly population is at a higher risk. It is important to understand these factors to design better intervention plans and enhance the quality of life of patients with protein malnutrition.
References
Dent, E., Wright, O. R., Woo, J., & Hoogendijk, E. O. (2023). Malnutrition in older adults. The Lancet, 401(10380), 951-966. https://doi.org/10.1016/S0140-6736(22)02612-5Links to an external site.
Norman, K., Haß, U., & Pirlich, M. (2021). Malnutrition in older adults—recent advances and remaining challenges. Nutrients, 13(8), 2764. https://doi.org/10.3390/nu13082764Links to an external site.
Serón-Arbeloa, C., Labarta-Monzón, L., Puzo-Foncillas, J., Mallor-Bonet, T., Lafita-López, A., Bueno-Vidales, N., & Montoro-Huguet, M. (2022). Malnutrition screening and assessment. Nutrients, 14(12), 2392. https://doi.org/10.3390/nu14122392Links to an external site.
