Pancreatic Enzyme Elevation in Adolescents with Eating Disorders

Kiesow, Kristen; Shahid, Novera; Park, Courtney Cheek; Weaver, Laurel; Lantzouni, Eleni; Peebles, Rebecka

doi:10.1016/j.jadohealth.2017.11.204

Cited by 2 publications

(1 citation statement)

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“…Cuntz et al (2000) found in those with EDs ( n = 109, 86 with AN) that restoration of pancreatic mass during weight restoration exceeded pancreatic size expectations, suggesting that the characteristic radiologic findings—increased pancreatic volume with decreased echogenicity—is problematic. Similarly, Kiesow et al (2018) reported in a study of 157 individuals (66% AN and 3% ARFID) that 34% presented with a high lipase level, 10% with a high amylase level, and that lower percent median BMI correlated with increased lipase levels; however, the elevated serum levels did not seem to indicate clinical pancreatitis. Humphries et al (1987) found 6 of 17 patients with AN to have elevated serum amylase, with five of these individuals having isolated salivary isoamylase activity and not of pancreatic origin; one individual in this study also had elevated lipase but no clinical evidence of pancreatitis.…”

Section: Resultsmentioning

confidence: 87%

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Gibson

Watters

Mehler

2021

Intl J Eating Disorders

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Objective Although multiple pathophysiologic changes develop within the gastrointestinal (GI) system in the setting of malnutrition, the etiology of the reported multitude of symptoms in those with anorexia nervosa and avoidant restrictive intake disorder, as well as their contribution toward disordered eating, remain poorly understood. This systematic review seeks to better understand how these physiologic changes of malnutrition of the esophagus, stomach, intestines, and pancreas contribute toward the reported GI symptoms, as well as better understand how celiac disease, inflammatory bowel disease, pelvic floor dysfunction, and Ehlers–Danlos syndrome contribute toward disordered eating. Methods Studies of any design exploring the pathogenesis of complications and treatment strategies were included. Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines were used to structure and complete the review. Results A total of 146 articles were used for the review. The majority of studies were observational or case reports/case series. Discussion Pathophysiologic changes of the esophagus, stomach, and intestines develop with malnutrition, although these changes do not consistently correlate with expressed GI symptoms in patients with restrictive eating disorders. Celiac disease and inflammatory bowel disease also contribute to disordered eating through the associated somatic GI complaints, while pelvic floor dysfunction and Ehlers–Danlos syndrome contribute through both somatic symptoms and functional symptoms. Indeed, functional GI symptoms remain problematic during the course of treatment, and further research is required to better understand the extent to which these symptoms are functional in nature and remit or remain as treatment ensues.

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Section: Resultsmentioning

confidence: 87%

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Gibson

Watters

Mehler

2021

Intl J Eating Disorders

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Unique considerations for the medical care of restrictive eating disorders in children and young adolescents

Tanner

2023

J Eat Disord

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Background The medical complications of eating disorders are often approached through an age-neutral lens. However, children and young adolescents may have unique medical complications related to the energy needs and timing of growth and development. Providers caring for patients in this vulnerable age range should understand how to identify, approach, and manage these potential age-related complications. Review Evidence continues to accumulate that increasingly younger patients are being diagnosed with eating disorders. These children and young adolescents have significant risk for unique and potentially irreversible medical complications. Without early identification and treatment, restrictive eating disorders may negatively impact linear growth, bone development and brain maturation in children and young adolescents. Additionally, due to the energy needs of growth and development, unique considerations exist for the use of acute medical stabilization and the identification of patients at risk for refeeding syndrome with initial nutritional rehabilitation. This review presents an approach to the evaluation and management of children and young adolescents with eating disorders. Conclusion Children and young adolescents with restrictive eating disorders may have unique medical complications related to the energy needs and timing of linear growth and pubertal development. Significant risk exists for irreversible medical complications of impaired growth, bone, and brain health. Increased awareness of the energy needs for growth and development may improve early recognition, appropriate intervention, and future outcomes for children and young adolescents with restrictive eating disorders.

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Pancreatic Enzyme Elevation in Adolescents with Eating Disorders

Cited by 2 publications

References 0 publications

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Unique considerations for the medical care of restrictive eating disorders in children and young adolescents

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