Compulsive Bowel Emptying and Rectal Prolapse in Eating Disorders. Presentation of Two Cases

Abstract

Eating Disorders are a heterogeneous group of complex psychiatric disorders that affect physical and psychological functioning, thus compromising life itself. They are often characterized by extreme preoccupation with food, caloric intake and expenditure as well as bodily weight and shape. Additionally, individuals present several forms of recurrent compulsive behavior, such as frequent weighting, body checking, and eating rituals. In many cases food consumption is considered a" failure" and its presence in the body "harmful and even "toxic" leading the individual to adopt a wide variety of purging behaviors in order to achieve a state of mental and physical "cleanliness" Two cases of compulsive bowel emptying, one suffering from Anorexia Nervosa and one suffering from Bulimia Nervosa, are presented. The compulsive bowel emptying behavior compromised of repeated and/or prolonged voluntary tension of the abdominal and pelvic muscles as well as insertion of the figure in the rectum to "check" if the bowel has been completely empty of its content. The purpose of this behavior was to alleviate intense anxiety caused by obsessive thoughts that the individual would get "fat" and/or "dirty/intoxicated" if the bowel was not completely vacated of the stools. In both cases the compulsive behavior facilitated the manifestation of rectum prolapse that reinforced the vicious circle of the obsessive-compulsive symptomatology. diet pills and anxiolytic) overdosing are the main causative factors of ED medical complications.