Skip to main content
PMC home page
Gut logoLink to Gut
. 1986 Oct;27(10):1120–1126. doi: 10.1136/gut.27.10.1120

Oesophageal and gastric motility disorders in patients categorised as having primary anorexia nervosa.

G Stacher, A Kiss, S Wiesnagrotzki, H Bergmann, J Höbart, C Schneider
PMCID: PMC1433863  PMID: 3781322

Abstract

Gastrointestinal motor function in patients with primary anorexia nervosa has rarely been investigated. We studied oesophageal motor activity in 30 consecutive patients meeting standard diagnostic criteria for primary anorexia nervosa (Feighner et al; DSM III). Seven were found to suffer from achalasia instead of primary anorexia nervosa, one from diffuse oesophageal spasm and one from severe gastro-oesophageal reflux and upper oesophageal sphincter hypertonicity, while partly non-propulsive and repetitive high amplitude, long duration contractions prevailed in the lower oesophagus of another six. In four patients with oesophageal dysmotility not responding to therapy and in 12 of 15 patients with normal oesophageal manometry, gastric emptying of a semisolid meal was studied. Emptying was normal in only three but markedly delayed in 13 cases (half emptying times 97-330 min, median: 147 min, as compared with 21-119 min, median: 47 min, in 24 healthy controls). In eight patients, the effects of domperidone 10 mg iv and placebo were compared under random double blind conditions. Half emptying times were shortened significantly (p less than 0.01) by domperidone. Conclusions: symptoms of disordered upper gastrointestinal motor activity may be mistaken as indicating primary anorexia nervosa; clinical evaluation of patients with presumed primary anorexia nervosa should rule out the possibility that disordered oesophageal motor activity underlies the symptoms; delayed gastric emptying is a frequent feature in primary anorexia nervosa and might be returned to normal with domperidone.

Full text

PDF
1120

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Evans D. S. Acute dilatation and spontaneous rupture of the stomach. Br J Surg. 1968 Dec;55(12):940–942. doi: 10.1002/bjs.1800551215. [DOI] [PubMed] [Google Scholar]
  2. Feighner J. P., Robins E., Guze S. B., Woodruff R. A., Jr, Winokur G., Munoz R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry. 1972 Jan;26(1):57–63. doi: 10.1001/archpsyc.1972.01750190059011. [DOI] [PubMed] [Google Scholar]
  3. Haller J. O., Slovis T. L., Baker D. H., Berdon W. E., Silverman J. A. Anorexia nervosa - the paucity of radiologic findings in more than fifty patients. Pediatr Radiol. 1977 Mar 17;5(3):145–147. doi: 10.1007/BF00973980. [DOI] [PubMed] [Google Scholar]
  4. Holt S., Ford M. J., Grant S., Heading R. C. Abnormal gastric emptying in primary anorexia nervosa. Br J Psychiatry. 1981 Dec;139:550–552. doi: 10.1192/bjp.139.6.550. [DOI] [PubMed] [Google Scholar]
  5. Horowitz M., Harding P. E., Chatterton B. E., Collins P. J., Shearman D. J. Acute and chronic effects of domperidone on gastric emptying in diabetic autonomic neuropathy. Dig Dis Sci. 1985 Jan;30(1):1–9. doi: 10.1007/BF01318363. [DOI] [PubMed] [Google Scholar]
  6. Jennings K. P., Klidjian A. M. Acute gastric dilatation in anorexia nervosa. Br Med J. 1974 Jun 1;2(5917):477–478. doi: 10.1136/bmj.2.5917.477. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lavigne M. E., Wiley Z. D., Meyer J. H., Martin P., MacGregor I. L. Gastric emptying rates of solid food in relation to body size. Gastroenterology. 1978 Jun;74(6):1258–1260. [PubMed] [Google Scholar]
  8. MARKOWSKI B. Acute dilatation of the stomach. Br Med J. 1947 Jul 26;2(4516):128–130. doi: 10.1136/bmj.2.4516.128. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. McCallum R. W., Grill B. B., Lange R., Planky M., Glass E. E., Greenfeld D. G. Definition of a gastric emptying abnormality in patients with anorexia nervosa. Dig Dis Sci. 1985 Aug;30(8):713–722. doi: 10.1007/BF01320484. [DOI] [PubMed] [Google Scholar]
  10. Richter J. E., Castell D. O. Diffuse esophageal spasm: a reappraisal. Ann Intern Med. 1984 Feb;100(2):242–245. doi: 10.7326/0003-4819-100-2-242. [DOI] [PubMed] [Google Scholar]
  11. Russell G. F. Acute dilatation of the stomach in a patient with anorexia nervosa. Br J Psychiatry. 1966 Feb;112(483):203–207. doi: 10.1192/bjp.112.483.203. [DOI] [PubMed] [Google Scholar]
  12. Saul S. H., Dekker A., Watson C. G. Acute gastric dilatation with infarction and perforation. Report of fatal outcome in patient with anorexia nervosa. Gut. 1981 Nov;22(11):978–983. doi: 10.1136/gut.22.11.978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Scobie B. A. Acute gastric dilatation and duodenal ileus in anorexia nervosa. Med J Aust. 1973 Nov 17;2(20):932–934. doi: 10.5694/j.1326-5377.1973.tb129824.x. [DOI] [PubMed] [Google Scholar]
  14. Stacher G., Bergmann H., Havlik E., Schmierer G., Schneider C. Effects of oral cyclotropium bromide, hyoscine N-butylbromide and placebo on gastric emptying and antral motor activity in healthy man. Gut. 1984 May;25(5):485–490. doi: 10.1136/gut.25.5.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wright R. A., Krinsky S., Fleeman C., Trujillo J., Teague E. Gastric emptying and obesity. Gastroenterology. 1983 Apr;84(4):747–751. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES