BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal adenocarcinoma.CASE SUMMARY Here,we present a case of...BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal adenocarcinoma.CASE SUMMARY Here,we present a case of a 47-year-old male patient referred to the gastroenterology clinic for upper endoscopy because he has a long-standing history of heartburn and vomiting after meals.On examination,he had characteristic findings of self-induced vomiting as abrasions and callosities on the dorsum of the right hand and dental erosions.A detailed history revealed that he had 17 years of binge eating with self-induced vomiting.His upper endoscopy showed gastroesophageal reflux grade D with salmon-red mucosal projections,and the biopsy revealed intestinal mucosal metaplasia.CONCLUSION This case emphasized the importance of considering upper endoscopy screening for Barrett’s esophagus in patients with eating disorders,especially those with self-induced vomiting,as in bulimia nervosa.展开更多
Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future...Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future therapeutic advances. Methods: Search for cholecystokinin AND bulimia nervosa in Pubmed Central, with no limits, identified 38 articles published up to the present date. Results: It is well established that CCK is altered in the pathogenesis of BN, and that its main role is in the perpetuation of the disorder rather than the cause of it. Discussion: Additional studies will be needed to further understand the mechanisms by which CCK regulates orexigenic pathways. If an orally active, longer acting analogue of CCK could be developed, it would be of significant interest as an appetite suppressant and a key adjuvant in the treatment of patients suffering from BN, particularly in refractory cases.展开更多
斐济,南太平洋的一个美丽岛国,在1985年尚不通电。但是,随着通电而来的电视,给这个岛国带来了意料不到的变化！昔日,该国的少男少女均以强健和肌肉发达为美,为追求。而今,小小的电视荧屏让他们看到了外面的世界,知道了Western ideals of...斐济,南太平洋的一个美丽岛国,在1985年尚不通电。但是,随着通电而来的电视,给这个岛国带来了意料不到的变化！昔日,该国的少男少女均以强健和肌肉发达为美,为追求。而今,小小的电视荧屏让他们看到了外面的世界,知道了Western ideals of beauty。从此,少女们开始diet(节食减肥),孰料,少女减肥不当,减出了bulimia(易饿病)and anorexia(厌食)。电视的出现是祸是福?作者意味深长地“重温”了19世纪的历史:When the British came to Fiji andbrought the measles 【医】麻疹)with them.接着,作者写道:in the 20th century,television is another pathogen(病原体)exporting Western images and values.】展开更多
AIM:To compare the prevalence of Functional gastrointestinal disorders(FGIDs)using ROMEⅢand ROMEⅡand to describe predictors of FGIDs among eating disorder(ED)patients.METHODS:Two similar cohorts of female ED inpatie...AIM:To compare the prevalence of Functional gastrointestinal disorders(FGIDs)using ROMEⅢand ROMEⅡand to describe predictors of FGIDs among eating disorder(ED)patients.METHODS:Two similar cohorts of female ED inpatients,aged 17-50 years,with no organic gastrointestinal or systemic disorders,completed either the ROMEⅢ(n=100)or the ROMEⅡ(n=160)questionnaire on admission for ED treatment.The two ROME cohorts were compared on continuous demographic variables(e.g.,age,BMI)using Student’s t-tests,and on categorical variables(e.g.,ED diagnosis)usingχ2-tests.The relationship between ED diagnostic subtypes and FGID categories was explored usingχ2-tests.Age,BMI,and psychological and behavioural predictors of the common(prevalence greater than 20%)ROMEⅢFGIDs were tested using logistic regression analyses.RESULTS:The criteria for at least one FGID were fulfilled by 83%of the ROMEⅢcohort,and 94%of the ROMEⅡcohort.There were no significant differences in age,BMI,lowest ever BMI,ED diagnostic subtypes or ED-related quality of life(QOL)scores between ROMEⅡand ROMEⅢcohorts.The most prevalent FGIDs using ROMEⅢwere postprandial distress syndrome(PDS)(45%)and irritable bowel syndrome(IBS)(41%),followed by unspecified functional bowel disorders(U-FBD)(24%),and functional heartburn(FH)(22%).There was a 29%or 46%increase(depending on presence or absence of cyclic vomiting)in functional gastroduodenal disorders because of the introduction of PDS in ROMEⅢcompared to ROMEⅡ.There was a 35%decrease in functional bowel disorders(FBD)in RomeⅢ(excluding U-FBD)compared to ROMEⅡ.The most significant predictor of PDS was starvation(P=0.008).The predictor of FH(P=0.021)and U-FBD(P=0.007)was somatisation,and of IBS laxative use(P=0.025).Age and BMI were not significant predictors.The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROMEⅢadded precision to many FGIDs.CONCLUSION:ROMEⅢconfers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting.Psychological factors appear to be more influential in ROMEⅡthan ROMEⅢ.展开更多
Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, th...Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially diff icult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following compo- nents: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight andshape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.展开更多
Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal o...Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall.展开更多
A 34-year-old woman presented at our hospital withabdominal distention due to overeating.Acute gastric dilatation was diagnosed.The patient was hospitalized,and nasogastric decompression was initiated.On hospitalizati...A 34-year-old woman presented at our hospital withabdominal distention due to overeating.Acute gastric dilatation was diagnosed.The patient was hospitalized,and nasogastric decompression was initiated.On hospitalization day 3,she developed shock,and her respiratory state deteriorated,requiring intubation and mechanical ventilation.Nasogastric decompression contributed to the improvement in her clinical condition.She was discharged 3 mo after admission.During outpatient follow-up,her dietary intake decreased,and her body weight gradually decreased by 14 kg.An upper gastrointestinal series and endoscopy revealed pyloric stenosis; therefore,we performed gastrojejunostomy 18 mo after her initial admission.The patient was discharged from the hospital with no postoperative complications.Gastric necrosis and perforation due to overeating-induced gastric dilatation are life-threatening conditions.Surgical intervention may be required if delayed pyloric stenosis occurs after conservative treatment.We report a case of pyloric stenosis due to overeating-induced gastric dilatation treated by gastrojejunostomy 18 mo after the initial presentation.展开更多
文摘BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal adenocarcinoma.CASE SUMMARY Here,we present a case of a 47-year-old male patient referred to the gastroenterology clinic for upper endoscopy because he has a long-standing history of heartburn and vomiting after meals.On examination,he had characteristic findings of self-induced vomiting as abrasions and callosities on the dorsum of the right hand and dental erosions.A detailed history revealed that he had 17 years of binge eating with self-induced vomiting.His upper endoscopy showed gastroesophageal reflux grade D with salmon-red mucosal projections,and the biopsy revealed intestinal mucosal metaplasia.CONCLUSION This case emphasized the importance of considering upper endoscopy screening for Barrett’s esophagus in patients with eating disorders,especially those with self-induced vomiting,as in bulimia nervosa.
文摘Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future therapeutic advances. Methods: Search for cholecystokinin AND bulimia nervosa in Pubmed Central, with no limits, identified 38 articles published up to the present date. Results: It is well established that CCK is altered in the pathogenesis of BN, and that its main role is in the perpetuation of the disorder rather than the cause of it. Discussion: Additional studies will be needed to further understand the mechanisms by which CCK regulates orexigenic pathways. If an orally active, longer acting analogue of CCK could be developed, it would be of significant interest as an appetite suppressant and a key adjuvant in the treatment of patients suffering from BN, particularly in refractory cases.
文摘斐济,南太平洋的一个美丽岛国,在1985年尚不通电。但是,随着通电而来的电视,给这个岛国带来了意料不到的变化！昔日,该国的少男少女均以强健和肌肉发达为美,为追求。而今,小小的电视荧屏让他们看到了外面的世界,知道了Western ideals of beauty。从此,少女们开始diet(节食减肥),孰料,少女减肥不当,减出了bulimia(易饿病)and anorexia(厌食)。电视的出现是祸是福?作者意味深长地“重温”了19世纪的历史:When the British came to Fiji andbrought the measles 【医】麻疹)with them.接着,作者写道:in the 20th century,television is another pathogen(病原体)exporting Western images and values.】
文摘AIM:To compare the prevalence of Functional gastrointestinal disorders(FGIDs)using ROMEⅢand ROMEⅡand to describe predictors of FGIDs among eating disorder(ED)patients.METHODS:Two similar cohorts of female ED inpatients,aged 17-50 years,with no organic gastrointestinal or systemic disorders,completed either the ROMEⅢ(n=100)or the ROMEⅡ(n=160)questionnaire on admission for ED treatment.The two ROME cohorts were compared on continuous demographic variables(e.g.,age,BMI)using Student’s t-tests,and on categorical variables(e.g.,ED diagnosis)usingχ2-tests.The relationship between ED diagnostic subtypes and FGID categories was explored usingχ2-tests.Age,BMI,and psychological and behavioural predictors of the common(prevalence greater than 20%)ROMEⅢFGIDs were tested using logistic regression analyses.RESULTS:The criteria for at least one FGID were fulfilled by 83%of the ROMEⅢcohort,and 94%of the ROMEⅡcohort.There were no significant differences in age,BMI,lowest ever BMI,ED diagnostic subtypes or ED-related quality of life(QOL)scores between ROMEⅡand ROMEⅢcohorts.The most prevalent FGIDs using ROMEⅢwere postprandial distress syndrome(PDS)(45%)and irritable bowel syndrome(IBS)(41%),followed by unspecified functional bowel disorders(U-FBD)(24%),and functional heartburn(FH)(22%).There was a 29%or 46%increase(depending on presence or absence of cyclic vomiting)in functional gastroduodenal disorders because of the introduction of PDS in ROMEⅢcompared to ROMEⅡ.There was a 35%decrease in functional bowel disorders(FBD)in RomeⅢ(excluding U-FBD)compared to ROMEⅡ.The most significant predictor of PDS was starvation(P=0.008).The predictor of FH(P=0.021)and U-FBD(P=0.007)was somatisation,and of IBS laxative use(P=0.025).Age and BMI were not significant predictors.The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROMEⅢadded precision to many FGIDs.CONCLUSION:ROMEⅢconfers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting.Psychological factors appear to be more influential in ROMEⅡthan ROMEⅢ.
基金Supported by a grant from INCITE, Consellería Innovación e Industria, Galician Government
文摘Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially diff icult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following compo- nents: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight andshape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.
文摘Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall.
文摘A 34-year-old woman presented at our hospital withabdominal distention due to overeating.Acute gastric dilatation was diagnosed.The patient was hospitalized,and nasogastric decompression was initiated.On hospitalization day 3,she developed shock,and her respiratory state deteriorated,requiring intubation and mechanical ventilation.Nasogastric decompression contributed to the improvement in her clinical condition.She was discharged 3 mo after admission.During outpatient follow-up,her dietary intake decreased,and her body weight gradually decreased by 14 kg.An upper gastrointestinal series and endoscopy revealed pyloric stenosis; therefore,we performed gastrojejunostomy 18 mo after her initial admission.The patient was discharged from the hospital with no postoperative complications.Gastric necrosis and perforation due to overeating-induced gastric dilatation are life-threatening conditions.Surgical intervention may be required if delayed pyloric stenosis occurs after conservative treatment.We report a case of pyloric stenosis due to overeating-induced gastric dilatation treated by gastrojejunostomy 18 mo after the initial presentation.
