Delayed Gastric Emptying in Anorexic Adolescents Measured with the 13C Octanoic Acid Breath Test
Martine K. F. Docx, Kristin Verbeke, Annik Simons, Joost Weyler, José Ramet, Luc Mertens, Gigi Veereman-Wauters
Department of Child Psychiatry Queen Paola Children’s Hospital Antwerp Belgium and University of Antwerp, Belgium.
Department of Epidemiology and Social Medicine University of Antwerp, Belgium.
Department of Paediatric Gastroenterology and Nutrition, University Hospital Brussels, Belgium.
Department of Paediatrics Chronic Diseases Queen Paola Children’s Hospital Antwerp, Belgium.
Department of Paediatrics University Hospital Antwerp, Belgium.
Division of Cardiology. The Hospital for Sick Children, Toronto, Canada.
Laboratory for Digestion and Absorption, University Hospitals Leuven, Belgium.
DOI: 10.4236/fns.2012.38138   PDF   HTML     4,494 Downloads   6,484 Views   Citations

Abstract

Many gastrointestinal complaints and motility disorders are described in patients suffering from different eating disorders. These have a negative impact on refeeding. This report evaluated–on admission-gastric emptying of a standardized solid meal with 13C octanoic acid breath test in anorexic adolescents. The results were compared with age and gender matched controls. Gastric emptying data were related to a subjective symptom score. 21 Anorexic girls and 3 boys (mean age: 15.6 y ± 1.3 y), body mass index (mean 15.6 kg/m2 ± 1.6 kg/m2), weight loss (mean: 22.2% ± 10.7%) were studied. T? of the gastric emptying time exceeded the P95 in 14/24 (58%) patients, classified as having delayed gastric emptying (DGE). One patient (4%) had a T? exceeding P75 and was classified as slow (SGE), whereas 9/24 (38%) patients had normal gastric emptying (NGE). In comparison to NGE, subjects with DGE had significantly higher symptom scores (p = 0.01) and more weight loss. The DGE and SGE patients lost 25.29% and 21.38% of weight respectively, whereas a weight loss of 17.64% was found in anorexics with NGE. In conclusion, gastric emptying is delayed in patients with anorexia. This is associated with more significant gastrointestinal symptoms and higher weight loss.

Share and Cite:

M. Docx, K. Verbeke, A. Simons, J. Weyler, J. Ramet, L. Mertens and G. Veereman-Wauters, "Delayed Gastric Emptying in Anorexic Adolescents Measured with the 13C Octanoic Acid Breath Test," Food and Nutrition Sciences, Vol. 3 No. 8, 2012, pp. 1043-1047. doi: 10.4236/fns.2012.38138.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] S. Zipfel, I. Sammet, N. Rapps, W. Herzog, S. Herpertz and U. Martens, “Gastrointestinal Disturbances in Eating Disorders: Clinical and Neurobiological Aspects,” Autonomic Neuroscience: Basic and Clinical, Vol. 129, No. 1-2, 2006, pp. 99-106. doi:10.1016/j.autneu.2006.07.023
[2] H. Bruch, “Anorexia Nervosa,” In: A. E. Lindner, Ed., Emotional Factors in Gastrointestinal Illness, Excerpta Medica, Amsterdam, 1973, pp. 1-15.
[3] N. Rapps, P. Enck, U. Martens, I. Sammet, M. Teufel, B. Otto and S. Zipfel, “Digestive und Pr?digestive Funktionen bei Patienten mit Essst?ringen,” Z Gastroenterol, Vol. 45, 2007, pp. 273-280. doi:10.1055/s-2006-927383
[4] P. H. Robinson, M. Clarke and J. Barrett, “Determinants of Delayed Gastric Emptying in Anorexia Nervosa and Bulimia Nervosa,” Gut, Vol. 29, 1988, pp. 458-464. doi:10.1136/gut.29.4.458
[5] D .S. Cannon, I. L. Crawford and L. E. Carell, “Zinc Deficiency Conditions Aversions in Rats,” Physiology & Behavior, Vol. 42, No. 3, 1988, pp. 245-247. doi:10.1016/0031-9384(88)90077-7
[6] Inui, H. Ohano, M Myamoto, N. Aoyama, M. Uemoto, S. Baba and M. Kasuga, “Delayed Gastric Emptying in Bulimic Patients,” Lancet, Vol. 346, No. 8984, 1995, pp. 1173-1240. doi:10.1016/S0140-6736(95)92954-1
[7] C. J. McClain, L. L. Humphries, K. K. Hill and N. J. Nickl, “Gastrointestinal and Nutritional Aspects of Eating Disorders,” Journal of the American College of Nutrition, Vol. 12, No. 4, 1993, pp. 466-474.
[8] G. Stacher, A. Kiss, S. Wiesnagrotzki, H. Bergmann, J. H?bart and C. Schneider, “Oesophageal and Gastric Motility Disorders in Patients Categorised as Having Anorexia Nervosa,” Gut, Vol. 27, No. 10, 1986, pp. 1120- 1126. doi:10.1136/gut.27.10.1120
[9] M. Tweed-Kent, P. J. Fagenholz and H. B. Alam, “Acute Gastric Dilatation in a Patient with Anorexia Nervosa Binge/Purge Subtype,” Journal of Emergencies, Trauma and Shock, Vol. 3, No. 4, 2010, pp. 403-405. doi:10.4103/0974-2700.70774
[10] D. Maes, Y. F. Ghoos , B. J. Geypens, M. I. Hiel and P. J. Rutgeerts, “Relation between Gastric Emptying Rate and Energy Intake in Children Compared with Adults,” Gut, Vol. 36, No. 2, 1995, pp. 183-188. doi:10.1136/gut.36.2.183
[11] M. Van Den Driessche, “Study of Gastro-Intestinal Motility in Infants and Children Using 13C Breath Tests. Maturation of Gastric Emptying and Orocaecal Transit Time,” Acta Biomedica Lovaniensia 251, Leuven University Press, Leuven, 1991.
[12] American Psychiatric Association, “Diagnostic and Statistical Manual of Mental Disorders,” 4th Edition, Author, Washington, 1994.
[13] S. J. V. van Zanten, N. Chiba, D. Armstrong, A. B. Barkun, V. Mann, S. Escobedo, B. Chakraborty and K. Nevin, “Validation of a 7-Point Global Overall Symptom Scale to Measure the Severity of Dyspepsia Symptoms in Clinical Trials,” Alimentary Pharmacology & Therapeutics, Vol. 23, No. 4, 2006, pp. 521-529. doi:10.1111/j.1365-2036.2006.02774.x
[14] M. F. Rolland-Cachera, T. J. Cole, M. Sempé, J. Tichet, C. Rossignol and A. Charraud, “ Body Mass Index Variations: Centiles from Birth to 87 Years,” European Journal of Clinical Nutrition, Vol. 45, No. 1, 1991, pp. 13-21.
[15] Keys, J. Brozek and A. Henschel, “The Biology of Human Starvation,” University of Minnesota Press, Minneapolis, 1950, pp. 587-600.
[16] Kiss, H. Bergmann, T. A. Abatzi, C. Schneider, S. Wiesnagrotzki, J. H?bart, G. Steiner-Mittelbach, G. Gaupmann, A. Kugi and G. Stacher-Janotta, “Oesophageal and Gastric Motor Activity in Patients with Bulimia Nervosa,” Gut, Vol. 31, No. 3, 1990, pp. 259-265. doi:10.1136/gut.31.3.259
[17] D. Waldholtz and A. E. Andersen, “Gastrointestinal Symptoms in Anorexia Nervosa. A Prospective Study,” Gastroenterology, Vol. 98, No. 6, 1990, pp. 1415-1419.
[18] G. de Simone, L. Scalfi, M. Galderisi, A. Celentano, G. Di Biase, P. Tammaro, M. Garofalo, G. F. Mureddu, O. de Divitiis and Contaldo, “Cardiac Abnormalities in Young Women with Anorexia Nervosa,” British Heart Journal, Vol. 71, No. 3, 1994, pp. 287-292. doi:10.1136/hrt.71.3.287
[19] M. McLoughlin, E. Spargo, W. S. Wassif, D. J. Newham, T. J. Peters, P. L. Lantos and G. F. Russell, “Structural and Functional Changes in Skeletal Muscle in Anorexia Nervosa,” Acta Neuropathologica, Vol. 95, No. 6, 1998, pp. 632-640. doi:10.1007/s004010050850
[20] L. Benini, T. Todesco, L. Frulloni, R. D. Grave, P. Campagnola, F. Agugiaro, C. D. Cusumano, A. Gabbrielli and I. Vantini, “Esophageal Motility and Symptoms in Restricting and Binge-Eating/Purging Anorexia,” Digestive and Liver Disease, Vol. 42, No. 11, 2010, pp. 762-772. doi:10.1016/j.dld.2010.03.018
[21] R. A. Wright, S. Krinsky, C. Fleeman, J. Trujillo and E. Teague, “Gastric Emptying and Obesity,” Gastroenterology, Vol. 84, No. 4, 1983, pp. 747-751.
[22] P. A. Domstad, W.-J. Shih, L. Humphries, D. Deland and G. A. Digenis, “Radionuclide Gastric Emptying Studies in Patients with Anorexia Nervosa,” Journal of Nuclear Medicine, Vol. 28, No. 5, 1987, pp. 816-819.
[23] T. L. Abell, J. R. Malagelada , A. R. Lucas, M. L. Brown, M. Camilleri, V. L. Go, F; Azpiroz, C. W. Callaway, P. C. Kao and A. R. Zinsmeister, “Gastric Electromechanical and Function in Anorexia Nervosa,” Gastroenterology, Vol. 935, No. 5, 1987, pp. 958-965.
[24] Diamanti, F. Bracci, M. Gambarara, G. C. Ciofetta, T. Sabbi, A. Ponticelli, S. Marinucci, G. Bianco and M. Castro, “Gastric Electric Activity Assessed by Electrogastrography and Gastric Emptying Scintigraphy in Adolescents with Eating Disorder,” Journal of Pediatric Gastroenterology and Nutrition, Vol. 37, No. 1, 2003, pp. 35-41. doi:10.1097/00005176-200307000-00006

Copyright © 2021 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.