Abstract
Many gastrointestinal complaints and motility disorders are described in patients suffering from different eating disorders. These have a negative impact on refeeding. This report evaluated–on admission-gastric emptying of a standardized solid meal with 13C octanoic acid breath test in anorexic adolescents. The results were compared with age and gender matched controls. Gastric emptying data were related to a subjective symptom score. 21 Anorexic girls and 3 boys (mean age: 15.6 y ± 1.3 y), body mass index (mean 15.6 kg/m2 ± 1.6 kg/m2), weight loss (mean: 22.2% ± 10.7%) were studied. T? of the gastric emptying time exceeded the P95 in 14/24 (58%) patients, classified as having delayed gastric emptying (DGE). One patient (4%) had a T? exceeding P75 and was classified as slow (SGE), whereas 9/24 (38%) patients had normal gastric emptying (NGE). In comparison to NGE, subjects with DGE had significantly higher symptom scores (p = 0.01) and more weight loss. The DGE and SGE patients lost 25.29% and 21.38% of weight respectively, whereas a weight loss of 17.64% was found in anorexics with NGE. In conclusion, gastric emptying is delayed in patients with anorexia. This is associated with more significant gastrointestinal symptoms and higher weight loss.
Highlights
Anorexia is commonly associated with gastrointestinal complaints such as bloating, nausea, epigastric discomfort, belching and postprandial fullness 1
Gastric emptying data were related to a subjective symptom score. 21 anorexic girls and 3 boys, body mass index, weight loss were studied
The study was prospective as all patients with anorexia nervosa (AN) and severe gastrointestinal complaints admitted to our Eating Disorder Unit from 2007 till 2008 were scheduled to undergo a 13C octanoic acid breath test on admission
Summary
Anorexia is commonly associated with gastrointestinal complaints such as bloating, nausea, epigastric discomfort, belching and postprandial fullness 1. These symptoms have a negative impact on refeeding 2,3. Delayed gastric emptying has been found in both anorexic and bulimia patients mostly for solids and semi-solids, but not for liquids 4. It has long been debated whether delayed gastric emptying is influenced by the “fear to eat”— cited by Cannon in 1988 and by Inui in 1995 in their respective papers, or whether primary alterations in gastric motor function are the driving force 5-8. In rare cases dilatetion impairs circulation of the gastric wall and mucosa and may lead to gastric perforation
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