Department of Gastroenterology and Hepatology, University of South Carolina School of Medicine Greenville, Greenville, South Carolina; USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA; Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Am J Gastroenterol. 2021 Jan 1;116(1):68-76. doi: 10.14309/ajg.0000000000001029.
Eating disorders involve irregularities in eating behavior that may cause gastrointestinal (GI) symptoms. Consequently, many patients with eating disorders seek gastroenterological healthcare at some point in their illness, with many seeking this care even before they seek treatment for and/or diagnosed with their eating disorder. As such, the gastroenterology provider is in a unique position to identify, manage, and facilitate treatment for an eating disorder early in the course of the illness. Although assessing eating disorders is already a difficult task, the identification of eating disorders in patients with GI disease represents an even greater challenge. In particular, common GI symptoms, such as nausea, vomiting, and bloating, may disguise an eating disorder because these symptoms are often viewed as a sufficient impetus for dietary restriction and subsequent weight loss. In addition, the focus on identifying an organic etiology for the GI symptoms can distract providers from considering an eating disorder. During this prolonged diagnostic evaluation, the eating disorder can progress in severity and become more difficult to treat. Unfortunately, a misconception that hinders eating disorder detection is the notion that the rate or method of weight loss is associated with an eating disorder. Regardless of whether weight loss is slow or rapid, purposeful or accidental, eating disorder behaviors and thought patterns may be present. Unidentified eating disorders are not only dangerous in their own right but also can interfere with effective management of GI disease and its symptoms. As such, it is imperative for the GI provider to remain well versed in the identification of these diseases.
进食障碍涉及饮食行为的不规则，可能导致胃肠道（GI）症状。因此，许多患有进食障碍的患者在患病过程中的某个时候会寻求胃肠病学的医疗保健，许多患者甚至在寻求治疗和/或诊断进食障碍之前就已经寻求了这种保健。因此，胃肠病学提供者处于独特的位置，可以在疾病过程的早期识别、管理和促进进食障碍的治疗。尽管评估进食障碍已经是一项艰巨的任务，但在患有 GI 疾病的患者中识别进食障碍则代表着更大的挑战。特别是，常见的 GI 症状，如恶心、呕吐和腹胀，可能会掩盖进食障碍，因为这些症状通常被视为限制饮食和随后体重减轻的充分动机。此外，专注于识别 GI 症状的器质性病因可能会使提供者忽略进食障碍。在这种延长的诊断评估期间，进食障碍的严重程度可能会加重，并且更难治疗。不幸的是，一个阻碍进食障碍检测的误解是，体重减轻的速度或方法与进食障碍有关。无论体重减轻是缓慢还是迅速，是有意还是无意，进食障碍的行为和思维模式可能存在。未被识别的进食障碍不仅本身很危险，还会干扰对 GI 疾病及其症状的有效管理。因此，胃肠病学提供者必须精通这些疾病的识别。
