Original ArticleAnorectal Dysfunction in Constipated Women With Anorexia Nervosa
Section snippets
Patients and Controls
Twelve women with anorexia nervosa (age range, 19-29 years) were recruited for the study. The diagnosis of anorexia nervosa was made according to the criteria of the American Psychiatric Association.7 The patients were referred by psychiatrists for severe malnutrition, and all complained of chronic constipation, which they perceived as a disabling symptom. All patients also took at least 1 laxative dose per week. Constipation was defined as fewer than 2 bowel movements per week for at least 9
RESULTS
Table 1 shows overall demographic, clinical, and manometric data of the 12 anorexia nervosa patients who participated in the first part of the study. Comparison with manometric data obtained in controls revealed that significant differences were found concerning resting anal pressure (50.6±19.1 mm Hg in patients vs 83.1±24.4 mm Hg in controls; P=.003); threshold for urge to defecate (121±86.5 ±86.5 mL in patients vs 58.3±19.5 mL in controls; P=.01); and pelvic floor dyssynergia (41.7% in
DISCUSSION
Patients with anorexia nervosa may display motor abnormalities of the upper gut, including delayed gastric emptying.17, 18, 19 Many patients also complain of debilitating constipation, but it is unclear whether this complaint is due to a gastrointestinal pathophysiological process or represents a manifestation of distorted bodily perception. Unfortunately, the available data are few.
Kamal et al5 studied the overall delay in gastrointestinal transit time in 8 patients with anorexia nervosa
REFERENCES (26)
- et al.
Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa
Gastroenteroiogy
(1991) - et al.
A clinical study of patients with fecal incontinence and diarrhea
Gastroenterology
(1979) - et al.
Physiologic investigation of primary chronic constipation in children: comparison with the barium enema study
Gastmenterology
(1984) - et al.
Gastric electromechanical and neurohormonal function in anorexia nervosa
Gastroenterotogy
(1987) - et al.
Colonic motility in man: features in normal subjects and in patients with chronic idiopathic constipation
Am J Gaslroenterol
(1999) - et al.
Gastrointestinal symptoms in anorexia nervosa: a prospective study
Gastroenteroiogy
(1990) - et al.
Gastrointestinal symptoms in bulimia nervosa: effects of treatment
Am J Gastroenterot
(1995) - et al.
Eating disorders
N EnglJ Med
(1985) - et al.
Obesity, anorexia nervosa, and bulimia
- et al.
Colonic and anorectal function in constipated patients with anorexia nervosa
Am J Gastroenterol
(1997)
Diagnostic and Statistical Manual of Mental Disorders
Functional bowel disorders and functional abdominal pain
Gut
A new method for studying gut transit limes using radioopaque markers
Cut
Cited by (71)
The intersection between eating disorders and gastrointestinal disorders: a narrative review and practical guide
2023, The Lancet Gastroenterology and Hepatology“The role of L. reuteri DSM17938 in nutritional recovery and treatment of constipation in children and adolescents with anorexia nervosa - a randomized, double blind, placebo controlled study”
2021, Clinical Nutrition ESPENCitation Excerpt :Chun and colleagues [11] reported whole gut transit time of 86.6 ± 17.8 h in AN vs. 28 ± 8.6 h in controls. In the majority of the patients studied pre-and post-nutritional therapy, the colonic transit times normalized [10]. However, many patients still felt constipated [6,11].
Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition and physical health consequences
2021, Pharmacology and TherapeuticsFrequency of Eating Disorder Pathology Among Patients With Chronic Constipation and Contribution of Gastrointestinal-Specific Anxiety
2020, Clinical Gastroenterology and HepatologySomatic complications and nutritional management of anorexia nervosa
2019, Clinical Nutrition ExperimentalAn update on gastrointestinal disturbances in eating disorders
2019, Molecular and Cellular EndocrinologyCitation Excerpt :Lastly, pelvic floor dysfunction – possibly associated with reduced vitamin D levels (Demay, 2003) – might contribute to the impaired defecation (Cortes et al., 2003). It is likely that the increase of colonic transit time is responsible for the symptoms reported as it was restored by nutritional rehabilitation along with a decrease of symptoms (n = 23 and n = 24, respectively) (Chun et al., 1997; Chiarioni et al., 2000). Moreover, a pilot study (n = 5) showed that the application of ghrelin or ghrelin agonists might represent a possible symptomatic treatment (Hotta et al., 2009).