An update on gastrointestinal disturbances in eating disorders

Hetterich, Larissa; Mack, Isa; Giel, Katrin Elisabeth; Zipfel, Stephan; Stengel, Andreas

doi:10.1016/j.mce.2018.10.016

Cited by 46 publications

(44 citation statements)

References 86 publications

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“…Functional gastrointestinal disorders AN is frequently associated with functional gastrointestinal disorders, which exacerbate patient distress, decrease their quality of life and complicate disease treatment [49,50]. In particular, anorectic patients frequently suffer from delayed gastric emptying, constipation or visceral hypersensitivity.…”

Section: Potential Involvement Of Gut Microbiota In Anorexia Nervosa mentioning

confidence: 99%

“…In particular, anorectic patients frequently suffer from delayed gastric emptying, constipation or visceral hypersensitivity. These disorders challenge refeeding strategies resulting in low treatment acceptance and high dropout, increased anxiety linked to food consumption, and finally lead to prolonged nutritional and digestive impairments [49,50].…”

Section: Potential Involvement Of Gut Microbiota In Anorexia Nervosa mentioning

confidence: 99%

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Intestinal microbiota and Anorexia Nervosa

Bretón

Déchelotte

Ribet

2019

Clinical Nutrition Experimental

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Anorexia nervosa is an eating disorder characterized by a severe malnutrition, an intense fear of gaining weight and a disturbed self-body image. Anorexia is conventionally considered as a multifactorial disease depending on biological, psychological and socio-cultural factors. Among the different biological factors involved in this eating disorder, the gut microbiota has recently gained a lot of attention. Indeed, the identification of an intestinal microbiota dysbiosis in individuals with anorexia has opened new and promising lines of research. These researches focus in particular on the role of intestinal microorganisms in the functional gastrointestinal disorders associated with Anorexia, in anxiety and depression-related disorders as well as in the regulation of eating behavior. This review aims to present the current knowledge about the putative role of the gut microbiota in the pathogenesis, course and treatment of Anorexia nervosa.

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Section: Potential Involvement Of Gut Microbiota In Anorexia Nervosa mentioning

confidence: 99%

Section: Potential Involvement Of Gut Microbiota In Anorexia Nervosa mentioning

confidence: 99%

Intestinal microbiota and Anorexia Nervosa

Bretón

Déchelotte

Ribet

2019

Clinical Nutrition Experimental

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“…Studies reporting GI symptoms, complaints and complications in patients with ED are extremely heterogeneous in their aims, design, participants, measurements, treatments, and outcomes (18) making it difficult to maintain a clear overview of the topic. A systematic review of the literature across the range of EDs and the GI tract is currently lacking in the literature.…”

Section: Introductionmentioning

confidence: 99%

Which Symptoms, Complaints and Complications of the Gastrointestinal Tract Occur in Patients With Eating Disorders? A Systematic Review and Quantitative Analysis

Riedlinger¹,

Schmidt²,

Weiland³

et al. 2020

Front. Psychiatry

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Background: Eating disorders (ED) such as anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are often accompanied by a variety of psychological and physical comorbidities. Gastrointestinal (GI) symptoms are a classical feature in most patients with ED. The heterogeneity of studies on this topic is high, making it difficult to have a clear overview. The aim of this systematic review is therefore to provide an overview of subjectively and objectively measured differences and changes in the GI tract in patients with EDs, along with the occurrence of GI complications. Methods: A systematic literature search was conducted in PubMed, Web of Science, and Google Scholar to find all relevant studies examining GI problems in AN, BN, and BED. Quantitative analyses were performed for objective GI physiology measures where applicable. Results: The review differentiated between ED types and also between studies that report GI outcomes of ED in (i) human studies with an ED diagnosis excluding case reports that provide an overview of GI problems in ED and (ii) case reports with an ED diagnosis describing rare GI complications in ED. GI symptoms and impaired gastric transit times were frequent features of EDs with specific differences found for the ED types. During the time course of treatment, GI symptoms changed and/or improved but not completely. GI complications extended the range of GI problems observed, including a variety of serious complications such as gastric dilatation. Conclusions: Problems of the GI tract are frequent in patients with ED and it is likely that they complicate therapy, especially in patients with AN.

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“…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.…”

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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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An update on gastrointestinal disturbances in eating disorders

Cited by 46 publications

References 86 publications

Intestinal microbiota and Anorexia Nervosa

Intestinal microbiota and Anorexia Nervosa

Which Symptoms, Complaints and Complications of the Gastrointestinal Tract Occur in Patients With Eating Disorders? A Systematic Review and Quantitative Analysis

Eating Disorders and Gastrointestinal Diseases

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