The gastrointestinal tract in eating disorders

Is It an Eating Disorder or Achalasia or Both? A Literature Review and Diagnostic Challenges

“…Achalasia might be suspected if swallowing difficulties occur in public (Gravier, Naja, Blaise, & Cremniter, ), which contrasts with the characteristically furtive purging behaviour in BN not readily disclosed to others. Clinicians should be aware that (i) patients with longstanding or chronic BN may develop the ability to vomit voluntarily without mechanical stimulation (Mehler, ; Mehler, Birmingham, Crow, & Jahraus, ; Robinson, ) and (ii) individuals with achalasia may self‐induce vomiting to relieve pain and discomfort (Francavilla et al, ). Thus, the use of mechanical stimulation to induce vomiting, per se, may not reliably distinguish achalasia from an ED.…”

“…Clinician bias might also be present in misattribution of symptoms such as rapid weight loss to an ED, especially in young women. It has been cautioned that low weight alone ‘cannot be used to infer the presence of an ED’ (Robinson, ).…”

“…Eating Disorders or Achalasia D. L. Reas et al weight loss to an ED, especially in young women. It has been cautioned that low weight alone 'cannot be used to infer the presence of an ED' (Robinson, 2000). Second, initial testing might need to be repeated.…”

“…Galanakis et al (Mehler, 2011;Mehler, Birmingham, Crow, & Jahraus, 2010;Robinson, 2000) and (ii) individuals with achalasia may self-induce vomiting to relieve pain and discomfort (Francavilla et al, 2009). Thus, the use of mechanical stimulation to induce vomiting, per se, may not reliably distinguish achalasia from an ED.…”

Gastric Bezoar Causing Massive Gastric Distention and Functional Outlet Obstruction in a Patient With Bulimia Nervosa

“…Patients may experience an array of self-imposed negative effects on the gastrointestinal tract, which can oftentimes be the presenting symptom of a patient's underlying psychiatric disorder. Complications include gastroesophageal reflux disease and dyspepsia secondary to repetitive mucosal exposure to gastric contents, hematemesis and anemia caused by Mallory-Weiss tears, along with electrolyte disturbances related to gastric, colonic and renal losses [2,3]. A gastric bezoar is a rare complication of BN [4].…”