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Nervosa Anorexia Leads to Defaecatory Disorders Compared to General Population
Pierpaolo Sileri1, Iacoangeli Fabrizio2, Federica Starr2, Luana Franceschilli*1, Elisabetta De Luca1, Alessandra Di Giorgio1, Marilena Raniolo1, Maria Irene Bellini1, Stefano D' Ugo1, Achille Gaspari1
1surgery, university of rome tor vergata, Rome, Italy; 2Internal Medicine, University of Rome, Tor Vergata, Rome, Italy
Background: We have previously shown that Defaecatory Disorders (DDs) can be as high as 60% in obese patients and are reversed after bariatric surgery. Conversely, similar data on DDs in patients with nervosa anorexia have been overlooked. In this case-control study we evaluated the prevalence and type of DDs in patients with nervosa anorexia.
Patients And Methods: A questionnaire-based study was proposed to patients with nervosa anorexia. Data included mean body mass index (BMI), demographics, past medical, surgical and obstetrics histories, as well as eating disorders duration. Wexner Constipation Score (WCS) and the Faecal Incontinence Severity Index (FISI) questionnaires were used to evaluate constipation and incontinence. For the purpose of this study, we considered clinically relevant a WCS ≥5 and a FISI score ≥10. Data were compared to a matched control group with 18<BMI>28.
Results: a total of 32 anorexia patients (group A) accepted the study and 30 patients filled the questionnaires as matched control-group (group B). Overall, in group A mean BMI was 17±3 Kg/mq(2)(range 12-23); mean illness duration 5±3 (range 1-13); mean WCS was 10±5 (range 2-22), while mean FISI score was 6±8 (range 0-38). Overall, 90% of these patients reported DDs according to the above-mentioned scores. Thirty patients (94%) had WCS ≥5. Eleven patients (34%) had FISI score ≥10. While eleven patients (34%) reported combined abnormal scores. In Group B, mean BMI 21±3 (range 18-28); mean WCS was 3.8±3 (range 0-10), while FISI score was 0. Overall, 53% of these patients reported DDs according to the above-mentioned scores. Sixteen patients (53%) had WCS ≥5. None had FISI score ≥10. In group A, according to the illness duration (<5 years/>5 years) we found a statistical significance in terms of WCS ≥5 and FISI score ≥10 (p<0.0001, p<0.02). According to the WCS ≥5, we found a statistical significance between the two groups (p<0.0001).
Conclusion: Defaecatory Disorders are common in anorexia nervosa patients compared to general population. The risk of DDs increases with anorexia nervosa duration.
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