Defecatory disorders in anorexia nervosa: a clinical study

Sileri, Pierpaolo; Franceschilli, Luana; Lorenzo, Antonino De; Mezzani, Barbara; Todisco, P; Giorgi, Federica; Gaspari, Achille; Jacoangeli, Fabrizio

doi:10.1007/s10151-013-1068-x

Cited by 21 publications

(29 citation statements)

References 17 publications

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“…The frequency of 27.6% for constipation in patients with AN is in accordance with findings by Boyd, Abraham, and Kellow (2005) (24%) and more than twice as high as in the general population (12%) (Mugie et al, 2011), but lower than reported by Sileri et al (2014) The association between constipation and AN is in line with other findings regarding constipation, weight, BMI, and eating problems. A nationwide Swedish twin study revealed a large association between restrictive eating habits and gastrointestinal disorders (Täljemark, Råstam, Lichtenstein, Anckarsäter, & Kerekes, 2017).…”

Section: Frequency Of Constipationsupporting

confidence: 89%

Incontinence and constipation in adolescent patients with anorexia nervosa—Results of a multicenter study from a German web‐based registry for children and adolescents with anorexia nervosa

Mattheus

Wagner

Becker

et al. 2019

Intl J Eating Disorders

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Objective Nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) are common disorders in childhood and are frequently accompanied by comorbid psychiatric disorders. Despite a high association between urinary and fecal incontinence with psychiatric and neurodevelopmental disorders, research on comorbidity between incontinence and anorexia nervosa (AN) remains scarce. Yet, it is well known that somatic consequences of AN include metabolic and gastrointestinal disorders. The study sought to assess the prevalence of incontinence and constipation in children and adolescents with AN and to examine associations of these two symptoms with body weight at admission and with BMI changes during inpatient treatment. Methods Data collected between 2015 and 2017 by a multicenter German web‐based registry for AN were analyzed. Three hundred and forty‐eight patients with AN (96.3% female, mean age = 15.1 ± 1.8 years) were assessed regarding AN subtype, psychiatric comorbidity, body weight, incontinence, and constipation. Results Overall, 27.6% of patients had constipation, 1.8% had NE and 1.8% DUI. Prevalence of constipation did not significantly differ between AN subtypes. Constipation did not lead to any significant differences in weight/BMI changes during inpatient treatment. Discussion This is the largest study of incontinence and constipation in patients with AN, so far. Our results indicate that constipation is highly prevalent in adolescent patients with AN and reflects a clinically relevant condition. Despite, patients with AN do not have an increased prevalence of incontinence compared with the general population. Future studies should include medical examinations like ultrasound and physical examination of the lower abdomen to evaluate the severity of constipation.

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Section: Frequency Of Constipationsupporting

confidence: 89%

Incontinence and constipation in adolescent patients with anorexia nervosa—Results of a multicenter study from a German web‐based registry for children and adolescents with anorexia nervosa

Mattheus

Wagner

Becker

et al. 2019

Intl J Eating Disorders

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Section: Gi Complaints In Anmentioning

confidence: 99%

“…In a study of 85 individuals suffering from AN, 93% were diagnosed with defecatory disorders; noteworthy, the percentage of defecatory disorders rose to 75% when the illness lasted ≥5 years and even to 100% when body mass index (BMI) was <18 kg/m 2 (Sileri et al, 2014). Furthermore, 83% suffered from constipation, 84% from obstructed defecation syndrome, 64% from a combination of constipation and fecal incontinence, and 9% from fecal incontinence alone (Sileri et al, 2014). On average, the subjects with AN reached a score of 10 ± 5 in the Wexner constipation score (cut-off: <5), 12 ± 4 in the Altomare's obstructed defecation score (cut-off: <10), and 12 ± 9 in the fecal incontinence severity index (cut-off: <10; Sileri et al, 2014).…”

Section: Gi Complaints In Anmentioning

confidence: 99%

“…Furthermore, 83% suffered from constipation, 84% from obstructed defecation syndrome, 64% from a combination of constipation and fecal incontinence, and 9% from fecal incontinence alone (Sileri et al, 2014). On average, the subjects with AN reached a score of 10 ± 5 in the Wexner constipation score (cut-off: <5), 12 ± 4 in the Altomare's obstructed defecation score (cut-off: <10), and 12 ± 9 in the fecal incontinence severity index (cut-off: <10; Sileri et al, 2014).…”

Section: Gi Complaints In Anmentioning

confidence: 99%

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Gastrointestinal alterations in anorexia nervosa — A systematic review

Schalla

Stengel

2019

Euro Eating Disorders Rev

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Objective: Anorexia nervosa (AN) is an eating disorder characterized by body schema disruptions, underweight (>15% reduction of the ideal body weight or a body mass index <17.5 kg/m 2 ), self-induced weight reduction, and endocrine impairments. The three latter features greatly impact on most physiological functions including the cardiovascular, skeletal, reproductive, and the gastrointestinal system, which results in an increased mortality rate in affected individuals. Especially, gastrointestinal alterations are described as particularly bothersome by patients.Methods: To address the need for a better understanding of the interplay between AN and the gastrointestinal (GI) tract, a systematic data search in the databases Medline, Embase, and PsycINFO was conducted.Results: Over 1,235 studies were identified, out of these, 107 appropriate articles were selected and discussed in the present review.Conclusion: AN has large impact on GI alterations and symptoms; conversely, GI symptoms may also affect the manifestation and course of AN as discussed in the present review. Despite increasing data, several gaps in knowledge exist especially on the pathophysiology underlying the changes described. Highlights• Gastrointestinal alterations during AN can be observed in the whole GI tract. • AN is accompanied by a high level of gastrointestinal complaints. • AN is more often the cause than the result of GI dysfunction and complaints occurring in the course of this eating disorder.

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“…Constipation is nearly universal in AN, arising from the same calorie‐conservation strategy that causes gastroparesis: the body does not spend limited calories on nonessential functions. Slowed GI transit time allows more water absorption from the colon, worsening constipation, while pelvic floor dysfunction contributes to difficulties with defecation .…”

Section: Casesmentioning

confidence: 99%

Rare medical manifestations of severe restricting and purging: “Zebras,” missed diagnoses, and best practices

Gaudiani

Mehler

2015

Intl J Eating Disorders

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Defecatory disorders in anorexia nervosa: a clinical study

Abstract: Defecatory disorders are associated with anorexia nervosa and increased with the duration and severity of the illness.

Cited by 21 publications

References 17 publications

Incontinence and constipation in adolescent patients with anorexia nervosa—Results of a multicenter study from a German web‐based registry for children and adolescents with anorexia nervosa

Incontinence and constipation in adolescent patients with anorexia nervosa—Results of a multicenter study from a German web‐based registry for children and adolescents with anorexia nervosa

Gastrointestinal alterations in anorexia nervosa — A systematic review

Rare medical manifestations of severe restricting and purging: “Zebras,” missed diagnoses, and best practices

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