Rectal prolapse associated with anorexia nervosa: a case report and review of the literature

Mitchell, Nadine; Norris, Mark L.

doi:10.1186/2050-2974-1-39

Cited by 17 publications

(13 citation statements)

References 29 publications

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“…Rectal prolapse, the full thickness protrusion of the rectal wall through the anal canal, can be a rare complication of AN. Five cases of rectal prolapse and AN are described in the literature, from ages 16–40 years . Four of the five cases required surgical correction, although one patient refused the recommendation.…”

Section: Resultsmentioning

confidence: 99%

“…Five cases of rectal prolapse and AN are described in the literature, from ages 16-40 years. [167][168][169] Four of the five cases required surgical correction, although one patient refused the recommendation. Conservative management with fiber supplementation, polyethylene glycol (PEG) 3350, and pelvic floor strengthening exercises was successful in the remaining case.…”

Section: Ano-rectal Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Gastrointestinal complications associated with anorexia nervosa: A systematic review

Norris

Harrison

Isserlin

et al. 2015

Intl J Eating Disorders

127

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Section: Resultsmentioning

confidence: 99%

Section: Ano-rectal Complicationsmentioning

confidence: 99%

Gastrointestinal complications associated with anorexia nervosa: A systematic review

Norris

Harrison

Isserlin

et al. 2015

Intl J Eating Disorders

127

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“…During the process of vomiting, a deep breathing precedes the actual vomiting to protect the lungs from aspiration followed by a strong contraction of the diaphragm down with all the abdominal muscles to expel the contents of the stomach [104]. This repetitive intra-abdominal pressure in addition to constipation, pelvic floor weakness and over-exercise is considered the rationale for the relationship between BN and RP [100,105,106]. As previously mentioned, other common purging methods in bulimic patients are the laxative and enema abuse detected in 36.5% and 7.9% of patients with ED, respectively [107].…”

Section: Bulimia Nervosamentioning

confidence: 99%

Eating Disorders and Gastrointestinal Diseases

et al. 2019

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Eating disorders (ED) are frequently associated with a wide range of psychiatric or somatic comorbidities. The most relevant ED are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorders (BED). Patients with ED exhibit both upper and lower gastrointestinal (GI) symptoms. Evidence of alterations throughout the GI tract in ED will be analyzed given the role of the GI tract in food intake and its regulation. It remains a matter of debate whether GI disorders are inherent manifestations of ED or the results of malnutrition occurring from ED. Moreover, recent clinical studies have highlighted the growing role of intestinal microbiota in the pathogenesis of ED, making it possible to hypothesize a modulation of intestinal microbiota as a co-adjuvant to standard therapy. The aim of this review is to analyze the link between ED and GI diseases and to present, where known, the potential key factors underlying these conditions. Conclusions: The presence of GI disorders should be investigated in patients with ED. Screening for ED should also be encouraged in individuals seeking treatment for unexplained GI complaints to better address therapeutic issues that surround these difficult medical conditions. Nutrients 2019, 11, 3038 3 of 17 ED can be associated with anxiety or mood disorders; insomnia; as well as somatic complications such as cardiac alterations, hormonal imbalances and also a wide range of gastrointestinal (GI) symptoms [3].Prevalence estimate of lifetime AN is 0.8% [4]. The overall incidence rate of AN is around 7 per 100,000 persons; however, it is higher in 15-19 year old girls reaching 109.2 cases per 100,000. The incidence is increasing in Italy and other Western countries probably due to earlier diagnosis or earlier onset [5,6].The prevalence of BN is 0.28% [4]. The highest incidence rate of BN is 300 per 100,000 persons in women aged between 16 and 20 [7], although the age at onset is decreasing [5].BED are described in 0.85% of the population [4,8] and are frequently associated with medical comorbidities, especially obesity and its complications such as Type II diabetes mellitus, hypertension, and dyslipidemia [9]. Furthermore, BED may occur in a subset ranging from 27% to 47% in severely obese persons undergoing bariatric surgery [10].The previous edition of DSM (DSM-IV) [11], classified as "Eating Disorders Not Otherwise Specified (EDNOS)", is the ED that does not satisfy all the diagnostic criteria for AN or BN. Previously, EDNOS contained a huge and varied group of individuals and was the most commonly diagnosed ED. However, the DSM-V revised this ED type and called it "Other Specified Feeding or Eating Disorder" (OSFED). Moreover, the DSM-V introduced the definition of Avoidant/restrictive food intake disorder (ARFID) that was distinct from AN and BN in that there is no body image disturbance [2].The first description of AN in the 19th century revealed that the sufferers' reasons for self-starvation generally were strictly connected to inappetence, feelings of fullness and abdominal ...

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“…Indeed, two thirds of AN patients suffer from delayed colonic transit and 40% from pelvic floor dysfunction associated with constipation (Chiarioni et al, 2000), whereas rectal sensation, internal anal sphincter relaxation threshold, rectal compliance, sphincter pressures, and expulsion pattern were normal in those patients (Chun, Sokol, Kaye, Hutson, & Wald, 1997). In addition, several cases of rectal prolapse were reported that may result from pelvic floor muscle deficiency (Mitchell & Norris, 2013).…”

Section: Motility Of the Lower Gi Tractmentioning

confidence: 99%

Gastrointestinal alterations in anorexia nervosa — A systematic review

Schalla

Stengel

2019

Euro Eating Disorders Rev

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Objective: Anorexia nervosa (AN) is an eating disorder characterized by body schema disruptions, underweight (>15% reduction of the ideal body weight or a body mass index <17.5 kg/m 2 ), self-induced weight reduction, and endocrine impairments. The three latter features greatly impact on most physiological functions including the cardiovascular, skeletal, reproductive, and the gastrointestinal system, which results in an increased mortality rate in affected individuals. Especially, gastrointestinal alterations are described as particularly bothersome by patients.Methods: To address the need for a better understanding of the interplay between AN and the gastrointestinal (GI) tract, a systematic data search in the databases Medline, Embase, and PsycINFO was conducted.Results: Over 1,235 studies were identified, out of these, 107 appropriate articles were selected and discussed in the present review.Conclusion: AN has large impact on GI alterations and symptoms; conversely, GI symptoms may also affect the manifestation and course of AN as discussed in the present review. Despite increasing data, several gaps in knowledge exist especially on the pathophysiology underlying the changes described. Highlights• Gastrointestinal alterations during AN can be observed in the whole GI tract. • AN is accompanied by a high level of gastrointestinal complaints. • AN is more often the cause than the result of GI dysfunction and complaints occurring in the course of this eating disorder.

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Rectal prolapse associated with anorexia nervosa: a case report and review of the literature

Cited by 17 publications

References 29 publications

Gastrointestinal complications associated with anorexia nervosa: A systematic review

Gastrointestinal complications associated with anorexia nervosa: A systematic review

Eating Disorders and Gastrointestinal Diseases

Gastrointestinal alterations in anorexia nervosa — A systematic review

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