Rigaud D, Bedig G, Merrouche M, Vulpillat M, Bonfils S, Apfelbaum M
Gastroenterological Department, Bichat Hospital, Paris, France.
Dig Dis Sci. 1988 Aug;33(8):919-25. doi: 10.1007/BF01535985.
The effects of renutrition on gastric emptying and upper gastrointestinal symptoms were evaluated in 14 anorexia nervosa patients before and after weight gain. A double-isotope technique was used to measure gastric emptying of both the solid and the liquid phases of the meal. Upper gastrointestinal symptoms were frequent before renutrition, occurring in 78% of the patients. Among these symptoms, nausea, vomiting and gastric fullness were correlated well with slowing in gastric emptying of both solid and liquid phases of the meal, which was demonstrated, respectively, in 10 (71%) and nine (64%) of the 14 patients. For the 11 patients who subsequently gained body weight, we observed, without any pharmacological treatment, an improvement of gastric emptying of both solid and liquid phases of the meal in eight (73%) and seven (64%) patients, respectively. Gastric emptying was unchanged in the three other patients who gained very little weight during the time of the study. As gastric emptying improved, so did nausea, vomiting, and gastric fullness. In three patients who had initially gained weight, nausea and gastric fullness recurred, associated again in all cases with a delay in gastric emptying. In conclusion, in anorexia nervosa, delayed gastric emptying, which is a frequent feature and which is well correlated with some of the upper digestive complaints, can return to normal without any pharmacological treatment. In this improvement, psychological assistance may play a role, together with the correction of the malnutrition.
对14例神经性厌食症患者在体重增加前后进行了营养再补充对胃排空及上消化道症状影响的评估。采用双同位素技术测量进餐固体和液体相的胃排空情况。营养再补充前上消化道症状频发,14例患者中有78%出现症状。在这些症状中,恶心、呕吐和胃部饱胀与进餐固体和液体相胃排空减慢密切相关,14例患者中分别有10例(71%)和9例(64%)出现这种情况。对于随后体重增加的11例患者,在未进行任何药物治疗的情况下,我们观察到进餐固体相和液体相胃排空分别在8例(73%)和7例(64%)患者中得到改善。在研究期间体重增加很少的另外3例患者中,胃排空未发生变化。随着胃排空改善,恶心、呕吐和胃部饱胀也有所改善。在最初体重增加的3例患者中,恶心和胃部饱胀再次出现,所有病例均再次伴有胃排空延迟。总之,在神经性厌食症中,胃排空延迟是一个常见特征,且与一些上消化道不适密切相关,无需任何药物治疗即可恢复正常。在这种改善过程中,心理支持可能发挥作用,同时纠正营养不良也很重要。