Norris Mark L, Harrison Megan E, Isserlin Leanna, Robinson Amy, Feder Stephen, Sampson Margaret
Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Int J Eat Disord. 2016 Mar;49(3):216-37. doi: 10.1002/eat.22462. Epub 2015 Sep 26.
A systematic review identifying gastrointestinal (GI) complications attributable to anorexia nervosa (AN) was completed.
Studies of any design exploring the pathogenesis of complications and treatment strategies were included. The review was completed in accordance with PRISMA standards.
A total of 123 articles were retained, including one randomized control trial. The majority of included studies were case reports and case series. Controlled studies demonstrated that patients with AN were more likely to have delays in gastric motility, gastric emptying and intestinal transit than comparator groups although results were not uniform across all studies. Published reports suggest that complications can occur at any segment of the GI tract. These issues may derive as a consequence of severe malnourishment, from eating disorder related symptoms such as self-induced purging or from the refeeding process itself. Multiple studies noted that patients with AN report high rates of GI symptoms although in the few cases where medical testing was undertaken, correlations between self-reported symptoms and measurable pathology were not demonstrated.
GI complications may occur throughout the entire GI tract in patients with AN. It is recommended that clinicians use careful judgment when pursuing targeted investigation or introducing symptom specific treatments in response to GI complaints. Evidence suggests that most GI complications resolve with refeeding and cessation of ED symptoms.
完成一项系统性综述，以确定神经性厌食症（AN）所致的胃肠道（GI）并发症。
纳入任何探索并发症发病机制及治疗策略的研究设计。该综述按照PRISMA标准完成。
共保留123篇文章，包括一项随机对照试验。纳入的研究大多为病例报告和病例系列。对照研究表明，与对照组相比，AN患者更易出现胃动力、胃排空及肠道转运延迟，尽管并非所有研究结果都一致。已发表的报告表明，GI并发症可发生于胃肠道的任何部位。这些问题可能是严重营养不良的结果，或是饮食失调相关症状（如自我催吐）所致，亦或是重新进食过程本身造成的。多项研究指出，AN患者报告的GI症状发生率很高，尽管在少数进行医学检测的病例中，并未证实自我报告症状与可测量病理之间存在关联。
AN患者的GI并发症可能发生于整个胃肠道。建议临床医生在针对GI主诉进行有针对性的调查或引入症状特异性治疗时谨慎判断。有证据表明，大多数GI并发症可通过重新进食和停止饮食失调症状得到缓解。
