Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia

Maria E. Perez; Brian Coley; Wallace Crandall; Carlo Di Lorenzo; Terrill Bravender

doi:10.1016/j.jpeds.2013.03.011

Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia

Maria E. Perez^*, Brian Coley, Wallace Crandall, Carlo Di Lorenzo, Terrill Bravender

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

Objective: To examine gastric function, as well as the presence of somatic complaints, anxiety symptoms, and functional gastrointestinal disorders (FGIDs), in adolescents with anorexia nervosa (AN) before and after nutritional rehabilitation. Study design: Sixteen females with AN and 22 healthy controls with similar demographic profiles were included. Gastric emptying (measured as residual gastric volume) and gastric accommodation (measured as postprandial antral diameter) were assessed with abdominal ultrasonography. Participants completed the Children's Somatization Inventory (CSI), the Screen for Child Anxiety-Related Emotional Disorders, and the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version. All testing was repeated 3-4 months later. Results: Body mass index in the AN group improved over time (P =.012). Fasting gastric parameters were similar in the 2 groups. Maximum postprandial antral diameter was significantly greater in controls compared with the AN group (P =.008). Only adolescents with AN demonstrated a significant increase in maximum postprandial diameter at repeat testing (P =.009). There was no difference in residual gastric volume between the 2 groups. Initial CSI scores were higher in adolescents with AN (P <.0001), including higher scores for nausea and abdominal pain. CSI scores were significantly lower in adolescents with AN (P =.035). Initial scores on the Screen for Child Anxiety-Related Emotional Disorders were significantly higher in adolescents with AN (P =.0005), but did not change over time. Adolescents with AN met significantly more criteria for FGIDs (P =.003). Conclusion: Adolescents with AN have impaired gastric accommodation that improves after nutritional rehabilitation, have significantly more somatic complaints, and meet more criteria for anxiety disorders and FGIDs. After nutritional rehabilitation, somatization improves and FGIDs become less common, but symptoms of anxiety persist.

Original language	English (US)
Pages (from-to)	867-872.e1
Journal	Journal of Pediatrics
Volume	163
Issue number	3
DOIs	https://doi.org/10.1016/j.jpeds.2013.03.011
State	Published - Sep 2013
Externally published	Yes

Keywords

AN
Anorexia nervosa
Baseline/initial testing
Children's Somatization Inventory
CSI
FGID
Follow-up testing
Functional gastrointestinal disorder
QPGS-RIII
Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version
Residual gastric volume
RGV
SCARED
Screen for Child Anxiety-Related Emotional Disorders
T1
T2

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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10.1016/j.jpeds.2013.03.011

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@article{8b52f9cc8e72483c99e5b84b79cef939,

title = "Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia",

abstract = "Objective: To examine gastric function, as well as the presence of somatic complaints, anxiety symptoms, and functional gastrointestinal disorders (FGIDs), in adolescents with anorexia nervosa (AN) before and after nutritional rehabilitation. Study design: Sixteen females with AN and 22 healthy controls with similar demographic profiles were included. Gastric emptying (measured as residual gastric volume) and gastric accommodation (measured as postprandial antral diameter) were assessed with abdominal ultrasonography. Participants completed the Children's Somatization Inventory (CSI), the Screen for Child Anxiety-Related Emotional Disorders, and the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version. All testing was repeated 3-4 months later. Results: Body mass index in the AN group improved over time (P =.012). Fasting gastric parameters were similar in the 2 groups. Maximum postprandial antral diameter was significantly greater in controls compared with the AN group (P =.008). Only adolescents with AN demonstrated a significant increase in maximum postprandial diameter at repeat testing (P =.009). There was no difference in residual gastric volume between the 2 groups. Initial CSI scores were higher in adolescents with AN (P <.0001), including higher scores for nausea and abdominal pain. CSI scores were significantly lower in adolescents with AN (P =.035). Initial scores on the Screen for Child Anxiety-Related Emotional Disorders were significantly higher in adolescents with AN (P =.0005), but did not change over time. Adolescents with AN met significantly more criteria for FGIDs (P =.003). Conclusion: Adolescents with AN have impaired gastric accommodation that improves after nutritional rehabilitation, have significantly more somatic complaints, and meet more criteria for anxiety disorders and FGIDs. After nutritional rehabilitation, somatization improves and FGIDs become less common, but symptoms of anxiety persist.",

keywords = "AN, Anorexia nervosa, Baseline/initial testing, Children's Somatization Inventory, CSI, FGID, Follow-up testing, Functional gastrointestinal disorder, QPGS-RIII, Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version, Residual gastric volume, RGV, SCARED, Screen for Child Anxiety-Related Emotional Disorders, T1, T2",

author = "Perez, {Maria E.} and Brian Coley and Wallace Crandall and {Di Lorenzo}, Carlo and Terrill Bravender",

note = "Funding Information: Funded by an intramural grant from the Research Institute at Nationwide Children's Hospital , Columbus, Ohio. The authors declare no conflicts of interest. ",

year = "2013",

month = sep,

doi = "10.1016/j.jpeds.2013.03.011",

language = "English (US)",

volume = "163",

pages = "867--872.e1",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

number = "3",

}

TY - JOUR

T1 - Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia

AU - Perez, Maria E.

AU - Coley, Brian

AU - Crandall, Wallace

AU - Di Lorenzo, Carlo

AU - Bravender, Terrill

N1 - Funding Information: Funded by an intramural grant from the Research Institute at Nationwide Children's Hospital , Columbus, Ohio. The authors declare no conflicts of interest.

PY - 2013/9

Y1 - 2013/9

N2 - Objective: To examine gastric function, as well as the presence of somatic complaints, anxiety symptoms, and functional gastrointestinal disorders (FGIDs), in adolescents with anorexia nervosa (AN) before and after nutritional rehabilitation. Study design: Sixteen females with AN and 22 healthy controls with similar demographic profiles were included. Gastric emptying (measured as residual gastric volume) and gastric accommodation (measured as postprandial antral diameter) were assessed with abdominal ultrasonography. Participants completed the Children's Somatization Inventory (CSI), the Screen for Child Anxiety-Related Emotional Disorders, and the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version. All testing was repeated 3-4 months later. Results: Body mass index in the AN group improved over time (P =.012). Fasting gastric parameters were similar in the 2 groups. Maximum postprandial antral diameter was significantly greater in controls compared with the AN group (P =.008). Only adolescents with AN demonstrated a significant increase in maximum postprandial diameter at repeat testing (P =.009). There was no difference in residual gastric volume between the 2 groups. Initial CSI scores were higher in adolescents with AN (P <.0001), including higher scores for nausea and abdominal pain. CSI scores were significantly lower in adolescents with AN (P =.035). Initial scores on the Screen for Child Anxiety-Related Emotional Disorders were significantly higher in adolescents with AN (P =.0005), but did not change over time. Adolescents with AN met significantly more criteria for FGIDs (P =.003). Conclusion: Adolescents with AN have impaired gastric accommodation that improves after nutritional rehabilitation, have significantly more somatic complaints, and meet more criteria for anxiety disorders and FGIDs. After nutritional rehabilitation, somatization improves and FGIDs become less common, but symptoms of anxiety persist.

AB - Objective: To examine gastric function, as well as the presence of somatic complaints, anxiety symptoms, and functional gastrointestinal disorders (FGIDs), in adolescents with anorexia nervosa (AN) before and after nutritional rehabilitation. Study design: Sixteen females with AN and 22 healthy controls with similar demographic profiles were included. Gastric emptying (measured as residual gastric volume) and gastric accommodation (measured as postprandial antral diameter) were assessed with abdominal ultrasonography. Participants completed the Children's Somatization Inventory (CSI), the Screen for Child Anxiety-Related Emotional Disorders, and the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version. All testing was repeated 3-4 months later. Results: Body mass index in the AN group improved over time (P =.012). Fasting gastric parameters were similar in the 2 groups. Maximum postprandial antral diameter was significantly greater in controls compared with the AN group (P =.008). Only adolescents with AN demonstrated a significant increase in maximum postprandial diameter at repeat testing (P =.009). There was no difference in residual gastric volume between the 2 groups. Initial CSI scores were higher in adolescents with AN (P <.0001), including higher scores for nausea and abdominal pain. CSI scores were significantly lower in adolescents with AN (P =.035). Initial scores on the Screen for Child Anxiety-Related Emotional Disorders were significantly higher in adolescents with AN (P =.0005), but did not change over time. Adolescents with AN met significantly more criteria for FGIDs (P =.003). Conclusion: Adolescents with AN have impaired gastric accommodation that improves after nutritional rehabilitation, have significantly more somatic complaints, and meet more criteria for anxiety disorders and FGIDs. After nutritional rehabilitation, somatization improves and FGIDs become less common, but symptoms of anxiety persist.

KW - AN

KW - Anorexia nervosa

KW - Baseline/initial testing

KW - Children's Somatization Inventory

KW - CSI

KW - FGID

KW - Follow-up testing

KW - Functional gastrointestinal disorder

KW - QPGS-RIII

KW - Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version

KW - Residual gastric volume

KW - RGV

KW - SCARED

KW - Screen for Child Anxiety-Related Emotional Disorders

KW - T1

KW - T2

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SN - 0022-3476

VL - 163

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JO - Journal of Pediatrics

JF - Journal of Pediatrics

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ER -

Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia

Abstract

Keywords

ASJC Scopus subject areas

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