Enteric feeding in severe adolescent anorexia nervosa: A report of four cases

Abstract

Objective Refeeding patients with anorexia nervosa can be one of the more challenging aspects of their treatment, and particularly if all food and fluids are adamantly and persistently refused. Method If the decision is made to augment or replace oral feeds, the most common intervention is nasogastric feeding. Results Although this is often successful, a subset of patients manage to sabotage feeding via this route. Other means of delivering nutrition such as intravenous feeds are often impractical for long‐term use. Another alternative in such life‐threatening situations is the use of enteric feeds via gastrostomy or jejunostomy. This paper presents the successful use of such enteric feeding in four cases of severe adolescent anorexia nervosa. Discussion The psychological, legal, and ethical issues involved are discussed, concluding that gastrostomy and jejunostomy are valid lifesaving methods to feed highly resistant anorectic patients. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 28: 470–475, 2000.

Meal Support Therapy Reduces the Use of Nasogastric Feeding for Adolescents Hospitalized With Anorexia Nervosa

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Meal Support Therapy Reduces the Use of Nasogastric Feeding for Adolescents Hospitalized With Anorexia Nervosa

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Experience with image‐guided gastrostomy and gastrojejunostomy tubes in children and adolescents with primary psychiatric illness

“…Our findings support those of a recent description of the effectiveness of enterostomy feeding in four patients with severe anorexia nervosa. 13 However, investigators of the previous study encountered difficulty with G-tube tolerability in half of the four-patient sample (intentional interference with enterostomy feeding occurred in one patient and physical restraint during feeding was required by a second patient 13 ), which we did not experience. This may have been in part due to differences in the underlying psychopathology in our sample as compared to that of the previous investigators', the absence of self-image-related pathology in a minority of our sample may have increased the acceptability of refeeding for these patients.…”

A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

“…16 studies included patients with AN only. 9,10,20,21,22,25,[29][30][31][37][38][39]41,43,44,46 It is evident that there is a wide variety of practices regarding NG feeding in YP with eating disorders globally. 9,21,28 Most studies identi ed that between 10-20% 9,17,29,43 of YP admitted to a psychiatric or medical ward for ED treatment required NG, although in some studies this was signi cantly higher.…”

Meal Support Therapy Reduces the Use of Nasogastric Feeding for Adolescents Hospitalized With Anorexia Nervosa

“……”

Experience with image‐guided gastrostomy and gastrojejunostomy tubes in children and adolescents with primary psychiatric illness

“…Our findings support those of a recent description of the effectiveness of enterostomy feeding in four patients with severe anorexia nervosa. 13 However, investigators of the previous study encountered difficulty with G-tube tolerability in half of the four-patient sample (intentional interference with enterostomy feeding occurred in one patient and physical restraint during feeding was required by a second patient 13 ), which we did not experience. This may have been in part due to differences in the underlying psychopathology in our sample as compared to that of the previous investigators', the absence of self-image-related pathology in a minority of our sample may have increased the acceptability of refeeding for these patients.…”

A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

“…16 studies included patients with AN only. 9,10,20,21,22,25,[29][30][31][37][38][39]41,43,44,46 It is evident that there is a wide variety of practices regarding NG feeding in YP with eating disorders globally. 9,21,28 Most studies identi ed that between 10-20% 9,17,29,43 of YP admitted to a psychiatric or medical ward for ED treatment required NG, although in some studies this was signi cantly higher.…”

Meal Support Therapy Reduces the Use of Nasogastric Feeding for Adolescents Hospitalized With Anorexia Nervosa

“……”

Experience with image‐guided gastrostomy and gastrojejunostomy tubes in children and adolescents with primary psychiatric illness

“…Our findings support those of a recent description of the effectiveness of enterostomy feeding in four patients with severe anorexia nervosa. 13 However, investigators of the previous study encountered difficulty with G-tube tolerability in half of the four-patient sample (intentional interference with enterostomy feeding occurred in one patient and physical restraint during feeding was required by a second patient 13 ), which we did not experience. This may have been in part due to differences in the underlying psychopathology in our sample as compared to that of the previous investigators', the absence of self-image-related pathology in a minority of our sample may have increased the acceptability of refeeding for these patients.…”

A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders

“…16 studies included patients with AN only. 9,10,20,21,22,25,[29][30][31][37][38][39]41,43,44,46 It is evident that there is a wide variety of practices regarding NG feeding in YP with eating disorders globally. 9,21,28 Most studies identi ed that between 10-20% 9,17,29,43 of YP admitted to a psychiatric or medical ward for ED treatment required NG, although in some studies this was signi cantly higher.…”