What is early satiety?

Early satiety (ES) is an important symptom present in many illnesses, including cancer. To understand ES, we must first understand appetite regulation.1

• Appetite: food preference, selection and motivation to eat.

• Hunger: mental/psychological urge to eat.

• Satiation: termination of an eating episode.

• Satiety: inhibition of further eating episodes.

There is currently no definition. Attempts to describe it include: ‘the desire to eat associated with the subsequent inability to eat (except for small amounts) due to a sense of fullness’.2 With the above descriptors of appetite regulation, early satiation may be a more suitable term. Despite this, the term ‘early satiety’ is more common throughout the literature and in clinical practice.

ES and anorexia are both common in cancer and often confused. Given they are distinct symptoms, it is important to distinguish them. They can occur in tandem or independently from each other.3 Another difference is that while those with anorexia report less hunger, those with ES but no anorexia experience hunger like a normal appetite.4 Those with moderate to severe ES seem to also have anorexia.2 While ES is distinct from anorexia, they are associated as they constitute part of the same gastrointestinal symptom cluster (anorexia, ES, taste changes, weight loss).5 ES forms an important part of a wider cachexia-fatigue symptom cluster consisting of easy fatigue, weakness, anorexia, lack of energy, dry mouth, weight loss and taste changes.5 Of note, ES was also found to be separate from nausea and vomiting which suggests a different pathophysiology.

ES prevalence

Prevalence data in cancer are limited. ES has also been found to be more prevalent in women than men.6 Prevalence in advanced cancer ranges from 10% to 71%.4 6 7 Following oesophagectomy or gastrectomy, there appears to be a higher prevalence of ES. No definition results …