“Essential nutrients- micronutrients (vitamins, minerals, and antioxidants) and macronutrients (proteins, carbohydrates, fats)- are required for cells to function normally” (McCance & Huether, 2019). Proteins are very important nutrients and have many different functions in the body. Protein malnutrition is a deficiency of proteins in the body, and when there is a deficiency, the cells are affected by it.
In this scenario, we have an elderly man who is diagnosed with protein malabsorption. He presents with generalized edema of the extremities and abdomen and has a history of malabsorption syndrome and difficulty eating because he doesn’t have dentures. This patient has probably developed the protein malnutrition from both the malabsorption syndrome and the difficulty eating. He’s probably not taking in enough protein to begin with since he is having difficulty eating, and if he is taking in enough his body isn’t absorbing it properly. “People with chewing problems, especially edentulous subjects without dentures, have weight loss and an increased mortality which is probably mainly due to reduced nutrient intake. However, the masticatory process also appears to be crucial for optimal absorption of nutrients from some essential, harder food components such as meat and vegetables” (Keller & Layer, 2014). Chewing is necessary for the absorptions of some necessary nutrients from the foods we eat.
The patient presents with generalized edema of the abdomen and extremities. “Edema results from a loss of fluid balance between hydrostatic and oncotic pressures across capillary blood vessel walls. Albumin concentration contributes to the oncotic pressure, allowing the body to keep fluids within the vasculature. Antidiuretic hormone (ADH) increases in response to the hypovolemia, resulting in edema.” (Benjamin & Lappin, 2018). The body responds to a decrease in protein by holding on to water, thereby causing edema.
The physiologic response to the stimulus (protein malnutrition) was the edema. Swelling of the extremities and the abdomen was the body’s response to decreased levels of protein, albumin in particular which allowed for the body to hold on to water.
I believe that gender and genetics would have no effect on the body’s response to this disorder. It was noted that females are more prone to protein energy malnutrition. “Reports have also documented the influence of gender on PEM manifestations. In rural India, females were reportedly more prone to PEM than males. A report from Kenya, likewise documented the higher emergence of PEM in women” (Guleria, P., Kumar, V., & Guleria, S., 2017).
It was also noted that immune cells are affected by protein malnutrition.
Benjamin, O. & Lappin, S. L. (2018). Kwashiorkor. Treasure Island, Florida: StatPearls Publishing.
Guleria, P., Kumar, V., Guleria, S. (2017). Genetic Engineering: A Possible Strategy for Proterin-Energy Malnutrition Regulation. Molecular Biotechnolgy 59(11-12), 499-517. doi: 10.1007/s12033-017-0033-8
Keller, J. & Layer, P. (2014). The Pathophysiology of Malabsorption. Viszeralmedizin: Gastrointestinal Medicine and Surgery, 30(3), 150-154. doi: https://dx.doi.org/10.1159%2F000364794
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.