Frequency of gastroesophageal reflux disease in adolescent girls with anorexia nervosa

Abstract

Objectives: The aim of the study was to assess the incidence of gastroesophageal reflux disease (GERD) in young females with anorexia nervosa (AN).

Methods: Participation in the study was proposed to young females with AN aged 12-18 who were hospitalized in the Department of Child Psychiatry, Medical University of Warsaw. Exclusion criteria were psychiatric disorders other than AN and treatment with prokinetic drugs and/or antacids (such as proton pump inhibitors or histamine receptor antagonists) in the last 2 weeks prior to the study. Patients were interviewed for gastrointestinal symptoms that can be related to GERD. Anthropometric measurements were obtained to assess the nutritional condition of the patients, and all of them were subjected to 24-hour pH-impedance monitoring. The pH-impedance recording was considered abnormal when the total number of reflux episodes exceeded 70 and/or the overall esophageal acid exposure time exceeded 6%.

Results: 23 female patients with AN were included in the study. They reported numerous symptoms, e.g., epigastric pain, nausea, vomiting, heartburn, chest pain, or excessive belching. However, only 2 of them (8.7%) were diagnosed with GERD on the basis of 24-hour pH-impedance monitoring. Both were suffering from a restrictive subtype of anorexia.

Conclusions: Even if numerous gastrointestinal symptoms indicative of GERD are reported by patients with AN, diagnosis of the disease in this group should not be based on symptoms, but it should be confirmed in an objective examination, preferably pH-impedance test.

Keywords: anorexia nervosa; child psychiatry; gastroesophageal reflux disease.