Acute gastric dilatation due to binge eating may be fatal

Dinçel, Oğuzhan

doi:10.14744/nci.2016.72677

Cited by 7 publications

(14 citation statements)

References 9 publications

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“…Some case reports reported fatal outcomes caused by the extreme acute gastric dilation after a binge episode [85][86][87][88]. It has been hypothesized that the massive food intake might cause an acute gastric dilatation, compressing the gastric wall and producing necrosis and perforation of the stomach [87]. Kim et al [89] reported a case of a 26-year-old woman who developed after a binge episode a huge gastric distension associated with acute pancreatitis.…”

Section: Binge Eating Disordersmentioning

confidence: 99%

Eating Disorders and Gastrointestinal Diseases

et al. 2019

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Eating disorders (ED) are frequently associated with a wide range of psychiatric or somatic comorbidities. The most relevant ED are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorders (BED). Patients with ED exhibit both upper and lower gastrointestinal (GI) symptoms. Evidence of alterations throughout the GI tract in ED will be analyzed given the role of the GI tract in food intake and its regulation. It remains a matter of debate whether GI disorders are inherent manifestations of ED or the results of malnutrition occurring from ED. Moreover, recent clinical studies have highlighted the growing role of intestinal microbiota in the pathogenesis of ED, making it possible to hypothesize a modulation of intestinal microbiota as a co-adjuvant to standard therapy. The aim of this review is to analyze the link between ED and GI diseases and to present, where known, the potential key factors underlying these conditions. Conclusions: The presence of GI disorders should be investigated in patients with ED. Screening for ED should also be encouraged in individuals seeking treatment for unexplained GI complaints to better address therapeutic issues that surround these difficult medical conditions. Nutrients 2019, 11, 3038 3 of 17 ED can be associated with anxiety or mood disorders; insomnia; as well as somatic complications such as cardiac alterations, hormonal imbalances and also a wide range of gastrointestinal (GI) symptoms [3].Prevalence estimate of lifetime AN is 0.8% [4]. The overall incidence rate of AN is around 7 per 100,000 persons; however, it is higher in 15-19 year old girls reaching 109.2 cases per 100,000. The incidence is increasing in Italy and other Western countries probably due to earlier diagnosis or earlier onset [5,6].The prevalence of BN is 0.28% [4]. The highest incidence rate of BN is 300 per 100,000 persons in women aged between 16 and 20 [7], although the age at onset is decreasing [5].BED are described in 0.85% of the population [4,8] and are frequently associated with medical comorbidities, especially obesity and its complications such as Type II diabetes mellitus, hypertension, and dyslipidemia [9]. Furthermore, BED may occur in a subset ranging from 27% to 47% in severely obese persons undergoing bariatric surgery [10].The previous edition of DSM (DSM-IV) [11], classified as "Eating Disorders Not Otherwise Specified (EDNOS)", is the ED that does not satisfy all the diagnostic criteria for AN or BN. Previously, EDNOS contained a huge and varied group of individuals and was the most commonly diagnosed ED. However, the DSM-V revised this ED type and called it "Other Specified Feeding or Eating Disorder" (OSFED). Moreover, the DSM-V introduced the definition of Avoidant/restrictive food intake disorder (ARFID) that was distinct from AN and BN in that there is no body image disturbance [2].The first description of AN in the 19th century revealed that the sufferers' reasons for self-starvation generally were strictly connected to inappetence, feelings of fullness and abdominal ...

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Section: Binge Eating Disordersmentioning

confidence: 99%

Eating Disorders and Gastrointestinal Diseases

et al. 2019

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“…AGD without perforation can be managed conservatively in some cases [45,47]. However, with gastric perforation, definitive surgical management is necessary [36,45,47].…”

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

“…Imaging studies such as abdominal or chest X-ray may reveal gas distension and subdiaphragmatic free air in cases with perforation [45,47]. Abdominal CT remains the most useful imaging modality for diagnosis and revealing of aetiology [10,47]. Standard resuscitation protocols with intravenous fluid resuscitation [47], early antibiotic therapy in septic patients [66], as well as attempting gastric decompression can improve outcomes.…”

Section: Managementmentioning

confidence: 99%

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Binge-eating and sodium bicarbonate: a potent combination for gastric rupture in adults—two case reports and a review of literature

et al. 2022

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Background Disordered eating behaviour including binge-eating often results in significant medical conditions, which are at times fatal. It can result in acute gastric dilatation which can lead to ischemic necrosis and stomach rupture. Dyspepsia and bloating are common symptoms following binge eating. Patients commonly use over-the-counter medications like sodium bicarbonate or home remedies for relief. However, in very rare, reported cases, sodium bicarbonate has been attributed to cause acute gastric dilatation and spontaneous gastric rupture instead. Methods We report two cases of spontaneous gastric rupture following consumption of sodium bicarbonate containing antacids after a large meal, and a review of the literature of similar cases. Results A total of 36 cases were identified. Approximately half of the cases (47.2%) were correlated with eating disorders, with higher prevalence in females (69%) and a very high mortality rate (41.6%). Amongst the 36 cases, sodium bicarbonate ingestion was associated with 10 cases. The lesser curvature (36.1%) and anterior wall (33.3%) are the most common sites of rupture. Associated causes include binge-eating, gas release from sodium bicarbonate, gastric content fermentation, proximal and distal outlet obstruction, and muscular atony. Discussion Sudden distension and impaired emptying mechanism of the stomach is necessary for spontaneous gastric rupture to occur. Acute gastric dilatation with perforation requires definitive surgical management. There should be a low threshold of suspicion for patients presenting with severe abdominal pain and abdominal distension following an episode of binge-eating. There is a need for patient education around the use of over-the-counter medications or home remedies.

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“…Anorexia nervosa confers a high degree of mortality and morbidity, including gastrointestinal disturbances [1][2][3]. While not fully understood, gastric distention can result from erratic eating behaviors, which may lead to decreased gastric motility and delayed gastric emptying [4].…”

Section: Introductionmentioning

confidence: 99%

Acute gastric dilatation in a patient with severe anorexia nervosa: a case report

et al. 2021

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Background Acute gastric dilatation (AGD) leading to gastric necrosis and perforation has been reported to be a rare but fatal complication in young patients with eating disorders, particularly anorexia nervosa. Case presentation We report a case of a Canadian female patient presenting with mild abdominal pain, with a history of anorexia nervosa, the binge/purge subtype, who was found to have severe acute gastric dilatation on subsequent computed tomography imaging. Her clinical course was uncomplicated after gastric decompression. The cause of her AGD was thought to be secondary to dysmotility disorder caused by her anorexia nervosa. Conclusion Our case report demonstrates the importance of clinical identification of AGD and subsequent diagnosis and management. Because of the urgency to rule out obstruction or perforation through consultation or additional imaging modalities, recognition and correct diagnosis of this condition is necessary for appropriate patient management. In addition, our case report adds to an underreported but important complication of anorexia nervosa.

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Acute gastric dilatation due to binge eating may be fatal

Cited by 7 publications

References 9 publications

Eating Disorders and Gastrointestinal Diseases

Eating Disorders and Gastrointestinal Diseases

Binge-eating and sodium bicarbonate: a potent combination for gastric rupture in adults—two case reports and a review of literature

Acute gastric dilatation in a patient with severe anorexia nervosa: a case report

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