Anorectal dysfunction in constipated women with anorexia nervosa.

OBJECTIVE To evaluate anorectal and colonic function in a group of patients with anorexia nervosa complaining of chronic constipation. PATIENTS AND METHODS Twelve women (age range, 19-29 years) meeting the criteria for anorexia nervosa and complaining of chronic constipation were recruited for the study. A group of 12 healthy women served as controls. Colonic transit time was measured by a radiopaque marker technique. Anorectal manometry and a test of rectal sensation were carried out with use of standard techniques to measure pelvic floor dysfunction. A subgroup of 8 patients was retested after an adequate refeeding program was completed. RESULTS Eight (66.7%) of 12 patients with anorexia nervosa had slow colonic transit times, while 5 (41.7%) had pelvic floor dysfunction. Colonic transit time normalized in the 8 patients who completed the 4-week refeeding program. However, pelvic floor dysfunction did not normalize in these patients. CONCLUSIONS Patients with anorexia nervosa who complain of constipation have anorectal motor abnormalities. Delayed colonic transit time is probably due to abnormal eating behavior.

[1]  H. Bergmann,et al.  Alimentary tract andpancreas Oesophageal andgastric motility disorders inpatients categorised ashaving primary anorexia nervosa , 1986 .

[2]  F. Baldi,et al.  Function of the internal anal sphincter and rectal sensitivity in idiopathic constipation. , 1982, Digestion.

[3]  N. Read,et al.  A clinical study of patients with fecal incontinence and diarrhea. , 1979, Gastroenterology.

[4]  K W Heaton,et al.  Functional bowel disorders and functional abdominal pain , 1999, Gut.

[5]  K. Burgio,et al.  Constipation in the Elderly: Influence of Dietary, Psychological, and Physiological Factors , 1994, Journal of the American Geriatrics Society.

[6]  D. Louis,et al.  Physiologic investigation of primary chronic constipation in children: Comparison with the barium enema study , 1984 .

[7]  W. Whitehead,et al.  Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. , 1991, Gastroenterology.

[8]  W. Whitehead,et al.  Gastrointestinal symptoms in bulimia nervosa: effects of treatment. , 1995, The American journal of gastroenterology.

[9]  I. Kodner,et al.  Colon, rectal, and anal surgery: Current techniques and controversies , 1985 .

[10]  M. Pescatori,et al.  The sphincteric and sensory components of preserved continence after ileoanal reservoir. , 1984, Surgery, gynecology & obstetrics.

[11]  C. Bilder,et al.  Colonic motility in man: features in normal subjects and in patients with chronic idiopathic constipation , 1999, American Journal of Gastroenterology.

[12]  A. Zinsmeister,et al.  Gastric electromechanical and neurohormonal function in anorexia nervosa. , 1987, Gastroenterology.

[13]  V. Dickinson.  Maintenance of anal continence: a review of pelvic floor physiology. , 1978, Gut.

[14]  A E Andersen,et al.  Gastrointestinal symptoms in anorexia nervosa. A prospective study. , 1990, Gastroenterology.

[15]  S. Müller-lissner.  What has happened to the cathartic colon? , 1996, Gut.

[16]  W. Kaye,et al.  Colonic and anorectal function in constipated patients with anorexia nervosa. , 1997, The American journal of gastroenterology.

[17]  W. Whitehead,et al.  Report of an international workshop on management of constipation , 1991 .