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Gastrointestinal complications and refeeding guidelines in patients with anorexia nervosa

Żaneta Malczyk, +1 more
- 30 Apr 2017 - 
- Vol. 51, Iss: 2, pp 219-229
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TLDR
The issues of gastrointestinal symptoms and complications in the course of Anorexia nervosa, and the rules of nutritional therapy are approached.
Abstract
Anorexia nervosa (AN) is the third most common disorder, after obesity and asthma, in the population of adolescents between 13-18 years of age. Food intake reduction is associated with whole body dysfunction, affecting its physical, psychological and social spheres. As a result of starvation, dysfunction develops in virtually all systems and organs. However, most frequently patients with AN complain of digestive symptoms, such as a feeling of fullness after meals, pain in the upper abdomen, dysphagia, nausea, bloating and constipation. They can have mild functional character, but may also reflect serious complications, including diseases requiring urgent surgical intervention. In addition, gastric complaints may hinder nutritional management of AN. Care of AN patients requires cooperation of many specialists in the field of psychiatry, psychology, paediatrics, internal medicine and nutrition. However, it is often difficult to organize such a team. Therefore, we decided to approach the issues of gastrointestinal symptoms and complications in the course of AN, and the rules of nutritional therapy.

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Citations
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Journal ArticleDOI

Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition and physical health consequences.

TL;DR: For ED patients with a manic episode, olanzapine (plus fluoxetine) seems appropriate in AN and lamotrigine in BN and BED; whereas for bipolar depression, Olanz Zapine ( plus fluoxettine) seem appropriate in An and lorazepam in BNs.
Journal ArticleDOI

Gastrointestinal Interoception in Eating Disorders: Charting a New Path

TL;DR: Using the alimentary tract as well as recent developments in interoceptive neuroscience and predictive processing as a guide, the current review summarizes evidence of gastrointestinal inter-ceptive dysfunction in eating disorders as discussed by the authors .
Journal ArticleDOI

Backstage of Eating Disorder-About the Biological Mechanisms behind the Symptoms of Anorexia Nervosa.

TL;DR: Current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome–gut–brain axis are reviewed.
References
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Journal ArticleDOI

Gastrointestinal symptoms in anorexia nervosa: A prospective study

TL;DR: It is concluded that although severe gastrointestinal symptoms are common in anorexia nervosa, they improve significantly with refeeding, and specific gastrointestinal studies should be reserved for patients who do not gain weight or who have indications of independent digestive disease.
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Refeeding in anorexia nervosa: increased safety and efficiency through understanding the pathophysiology of protein calorie malnutrition.

TL;DR: Evidence for the use of continuous feeding strategies with less than 40% of calories from carbohydrates is presented, which has important implications for the prevention of the refeeding syndrome as well as the safety and efficiency with whichRefeeding may occur for children and adolescents with anorexia nervosa in hospital.
Journal ArticleDOI

Hypokalemia in outpatients with eating disorders.

TL;DR: The study suggests that hypokalemia in a patient with an eating disorder is virtually certain evidence that the patient is purging at least daily, and suggests that routine electrolyte determination is a poor screening tool for occult or denied bulimia.
Journal ArticleDOI

Anorectal dysfunction in constipated women with anorexia nervosa.

TL;DR: Patients with anorexia nervosa who complain of constipation have anorectal motor abnormalities and delayed colonic transit time is probably due to abnormal eating behavior.
Journal ArticleDOI

Gastric Emptying in Patients with Restricting and Binge/Purging Subtypes of Anorexia Nervosa

TL;DR: Gastric emptying derangement and dyspeptic symptoms are present in both subtypes of anorexia nervosa patients and long-term rehabilitation improves gastrointestinal symptoms, gastric empties, and psychopathological distress in an independent manner, whereas short-term refeeding does not.
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