Gastric dilatation in patients with restrictive eating disorders

Abstract

Objectives To better understand gastric dimensions in patients diagnosed with restrictive eating disorders (EDs). Method In this retrospective study, 56 patients, with restrictive EDs, and 60 gender/age/race‐matched patients from an outpatient clinic, were studied. Difference in stomach size, between cohorts, was ascertained, and regression analyses were used to examine associations with stomach size in the ED cohort. Results Patients with EDs were found to have significantly enlarged gastric dimensions when compared to the control group (M:14.8 cm [SD: 3.2] vs. 11.4 cm [SD: 2.9], p < .0001). Among the ED cohort, blood urea nitrogen (BUN), on the day of imaging, positively correlated with gastric dimensions (r = .43, p = .0009), while hypoalbuminemia negatively correlated with gastric dimensions (r = −.37, p = .005). BUN and albumin nadir were also significantly associated with stomach size (r2 = .26, F[2,53] = 9.46, p = .0003). There was no significant correlation between gastric dimensions and ED diagnosis, percent ideal body weight, gender, duration of illness, engagement in vomiting behaviors, diagnosis of superior mesenteric artery syndrome, or use of promotility agents. Discussion Findings in this study suggest that malnutrition, secondary to EDs, may be associated with an enlarged stomach. The relationship between the gastric dimensions and reported GI symptoms in this population remain to be determined. Public significance There are many physiologic changes to the gastrointestinal system that develop with malnutrition but the contribution of these physiologic changes toward the reported GI symptoms and refeeding difficulties is unclear. This is the first study to suggest that patients with malnutrition, secondary to EDs, may be associated with an enlarged stomach, and this potential relationship requires further investigation.

Stomach size in anorexia nervosa: A new challenge?

“…These data are in line with those recently reported from data obtained in a lying position by Gibson et al. (2022), among female patients suffering from restrictive eating disorders. Our findings corroborate the results of Gibson's study, highlighting the presence of gastric dilatation in AN, independently of the presence of radiological signs of SMAS, which were found in about a third of our patients.…”

“…The main objective of this study was to describe stomach morphometry on UGR in patients with AN, further to the study by Gibson et al. reporting gastric dilatation in patients with restrictive eating disorders using CT images (Gibson et al., 2022). To this end, we developed a novel SSI, calculated as the ratio of stomach height to abdominal height (described in Figure 1).…”

“…More recently, Gibson et al reported gastric enlargement in 56 AN subjects, who underwent computed tomography (CT) scan of their abdomen for various symptomatic reasons during a stay in the authors' acute centre for eating disorders. These patients were compared with 60 gender-, age-and race-matched patients from an outpatient clinic (Gibson et al, 2022).…”

Can we predict the development of acute gastric dilatation in patients with anorexia nervosa?

“…A paper recently published by Gibson et al (2022) [8] sought to define baseline gastric dimensions in patients with eating disorders. This study found that the average stomach size in patients with eating disorders was significantly larger than a control cohort, leading the authors to conclude that malnutrition, resulting from restrictive eating disorders may be associated with an enlarged stomach.…”