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Review
. 2019 Dec 12;11(12):3038.
doi: 10.3390/nu11123038.

Eating Disorders and Gastrointestinal Diseases

Antonella Santonicola  1 , Mario Gagliardi  1 , Michele Pier Luca Guarino  2 , Monica Siniscalchi  1 , Carolina Ciacci  1 , Paola Iovino  1
Affiliations
Review

Eating Disorders and Gastrointestinal Diseases

Antonella Santonicola et al. Nutrients. .

Abstract

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.

Keywords: anorexia nervosa; binge-eating disorders; bulimia nervosa; gastrointestinal diseases.

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Conflict of interest statement

The authors declare no conflicts of interest

Figures

Figure 1
Figure 1
The description of the three main types of Eating Disorders (adapted by the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), released by the American Psychiatric Association [2].
Figure 2
Figure 2
The most prevalent GI symptoms are shown taking into account different anatomical regions from esophagus to intestine in the three main ED disorders: AN, BN and BED.
Figure 3
Figure 3
The complex bidirectional communication between the central nervous system (CNS) and microbiota involving nervous, endocrine and immune systems that might contribute to the regulation of emotional behavior and cognition in intact and disrupted intestinal barriers.
See this image and copyright information in PMC

References

    1. Lewinsohn P.M., Hops H., Roberts R.E., Seeley J.R., Andrews J.A. Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J. Abnorm. Psychol. 1993;102:133–144. doi: 10.1037/0021-843X.102.1.133. - DOI - PubMed
    1. Association A.P. DSM—5. American Psychological Association; Washington, DC, USA: 2015. Diagnostic and statistical manual of mental disorders.
    1. Hetterich L., Mack I., Giel K.E., Zipfel S., Stengel A. An update on gastrointestinal disturbances in eating disorders. Mol. Cell. Endocrinol. 2018;497:110318. doi: 10.1016/j.mce.2018.10.016. - DOI - PubMed
    1. Udo T., Grilo C.M. Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biol. Psychiatry. 2018;84:345–354. doi: 10.1016/j.biopsych.2018.03.014. - DOI - PMC - PubMed
    1. Smink F.R., van Hoeken D., Hoek H.W. Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Curr. Psychiatry Rep. 2012;14:406–414. doi: 10.1007/s11920-012-0282-y. - DOI - PMC - PubMed

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