Heathcote Bridget, Carey Sharon
Nutrition and Dietetics Department, Royal Prince Alfred Hospital, Sydney, Australia.
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
J Hum Nutr Diet. 2025 Aug;38(4):e70100. doi: 10.1111/jhn.70100.
Constipation is a common nutrition impact symptom experienced by the eating disorder population.
The aim of this scoping review was to identify current recommendations and evidence for managing constipation within the eating disorders population, specifically anorexia nervosa (AN) and bulimia nervosa (BN).
Using a scoping review framework, a search of relevant databases (MEDLINE (Ovid), Cinahl, Web of Science and Embase) was undertaken using MESH terms. Keywords included: feeding and eating disorders', constipation', gastrointestinal disease'. Reference lists and grey literature were searched. Studies were included if they included a discussion on constipation management in eating disorders and published in English. Data was extracted from the papers; management options were categorized based on common themes.
Twenty-eight studies met inclusion criteria. Suggested management strategies from articles were categorized into five themes: weight restoration (including regular eating), fibre, fluid, medication (including laxative withdrawal) and education. The strongest recommendations are that normalization of weight positively reduces rates of constipation within four to twelve weeks. There is some consistency in recommendations for increased fibre intake, increased fluid intake, medication use and patient education, but conflicting recommendations on laxative withdrawal.
There is strong evidence to support for the role of weight restoration in the management of constipation in AN and BN. This is an area that needs more specialized research and practical recommendations particularly in regard to fibre, fluid, medication use, cessation of laxatives and patient and clinician education.
便秘是饮食失调人群常见的营养影响症状。
本综述的目的是确定饮食失调人群，特别是神经性厌食症（AN）和神经性贪食症（BN）患者便秘管理的当前建议和证据。
采用综述框架，使用医学主题词（MESH）检索相关数据库（MEDLINE（Ovid）、护理学与健康领域数据库（Cinahl）、科学引文索引（Web of Science）和荷兰医学文摘数据库（Embase））。关键词包括：喂养和饮食失调、便秘、胃肠疾病。检索了参考文献列表和灰色文献。如果研究包括饮食失调便秘管理的讨论且以英文发表，则纳入研究。从论文中提取数据；管理选项根据共同主题进行分类。
28项研究符合纳入标准。文章中建议的管理策略分为五个主题：体重恢复（包括规律饮食）、纤维、液体、药物（包括泻药停用）和教育。最有力的建议是体重正常化能在4至12周内有效降低便秘发生率。在增加纤维摄入量、增加液体摄入量、药物使用和患者教育方面的建议存在一定一致性，但在泻药停用方面存在相互矛盾的建议。
有强有力的证据支持体重恢复在神经性厌食症和神经性贪食症便秘管理中的作用。这是一个需要更多专门研究和实用建议的领域，特别是在纤维、液体、药物使用、泻药停用以及患者和临床医生教育方面。
