The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?-A systematic review.
anorexia nervosa
avoidant restrictive food intake disorder
functional
gastrointestinal system
pathophysiologic
systematic review
Journal
The International journal of eating disorders
ISSN: 1098-108X
Titre abrégé: Int J Eat Disord
Pays: United States
ID NLM: 8111226
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
22
04
2021
received:
29
12
2020
accepted:
08
05
2021
pubmed:
28
5
2021
medline:
16
10
2021
entrez:
27
5
2021
Statut:
ppublish
Résumé
Although multiple pathophysiologic changes develop within the gastrointestinal (GI) system in the setting of malnutrition, the etiology of the reported multitude of symptoms in those with anorexia nervosa and avoidant restrictive intake disorder, as well as their contribution toward disordered eating, remain poorly understood. This systematic review seeks to better understand how these physiologic changes of malnutrition of the esophagus, stomach, intestines, and pancreas contribute toward the reported GI symptoms, as well as better understand how celiac disease, inflammatory bowel disease, pelvic floor dysfunction, and Ehlers-Danlos syndrome contribute toward disordered eating. Studies of any design exploring the pathogenesis of complications and treatment strategies were included. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to structure and complete the review. A total of 146 articles were used for the review. The majority of studies were observational or case reports/case series. Pathophysiologic changes of the esophagus, stomach, and intestines develop with malnutrition, although these changes do not consistently correlate with expressed GI symptoms in patients with restrictive eating disorders. Celiac disease and inflammatory bowel disease also contribute to disordered eating through the associated somatic GI complaints, while pelvic floor dysfunction and Ehlers-Danlos syndrome contribute through both somatic symptoms and functional symptoms. Indeed, functional GI symptoms remain problematic during the course of treatment, and further research is required to better understand the extent to which these symptoms are functional in nature and remit or remain as treatment ensues. Aunque en el contexto de la desnutrición se desarrollan múltiples cambios fisiopatológicos dentro del sistema gastrointestinal (GI), la etiología de la multitud de síntomas reportados en aquellos que padecen anorexia nerviosa y trastorno evitativo restrictivo de la ingesta, así como su contribución a la alimentación disfuncional, siguen siendo poco entendidos. Esta revisión sistemática busca entender mejor cómo estos cambios fisiológicos de la desnutrición del esófago, estómago, intestinos y páncreas contribuyen a los síntomas gastrointestinales reportados, así como entender mejor cómo la enfermedad celíaca, la enfermedad inflamatoria intestinal, la disfunción del piso pélvico y el síndrome de Ehlers Danlos contribuyen a la alimentación disfuncional. MÉTODOS: Se incluyeron estudios de cualquier diseño que exploraran la patogénesis de las complicaciones y las estrategias de tratamiento. Los lineamientos PRISMA se utilizaron para estructurar y completar el examen. Se utilizaron un total de 146 artículos para la revisión. La mayoría de los estudios fueron observacionales o reporte de caso o series de casos. DISCUSIÓN: Los cambios fisiopatológicos del esófago, el estómago y los intestinos se desarrollan con la desnutrición, aunque estos cambios no se correlacionan consistentemente con los síntomas gastrointestinales expresados en pacientes con trastornos de la conducta alimentaria restrictivos. La enfermedad celíaca y la enfermedad inflamatoria intestinal también contribuyen a la alimentación disfuncional a través de las quejas gastrointestinales somáticas asociadas, mientras que la disfunción del piso pélvico y el síndrome de Ehlers Danlos contribuyen a través de síntomas somáticos y síntomas funcionales. De hecho, los síntomas gastrointestinales funcionales siguen siendo problemáticos durante el curso del tratamiento, y se requiere más investigación para comprender mejor hasta qué punto estos síntomas son de naturaleza funcional y se remiten o permanecen a medida que se produce el tratamiento.
Autres résumés
Type: Publisher
(spa)
Aunque en el contexto de la desnutrición se desarrollan múltiples cambios fisiopatológicos dentro del sistema gastrointestinal (GI), la etiología de la multitud de síntomas reportados en aquellos que padecen anorexia nerviosa y trastorno evitativo restrictivo de la ingesta, así como su contribución a la alimentación disfuncional, siguen siendo poco entendidos. Esta revisión sistemática busca entender mejor cómo estos cambios fisiológicos de la desnutrición del esófago, estómago, intestinos y páncreas contribuyen a los síntomas gastrointestinales reportados, así como entender mejor cómo la enfermedad celíaca, la enfermedad inflamatoria intestinal, la disfunción del piso pélvico y el síndrome de Ehlers Danlos contribuyen a la alimentación disfuncional. MÉTODOS: Se incluyeron estudios de cualquier diseño que exploraran la patogénesis de las complicaciones y las estrategias de tratamiento. Los lineamientos PRISMA se utilizaron para estructurar y completar el examen.
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1019-1054Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Aardoom, J., Dingemans, A., Spinhoven, P., & Van Furth, E. (2013). Treating eating disorders over the internet: A systematic review and future research directions. International Journal of Eating Disorders, 46(6), 539-552. https://doi.org/10.1002/eat.22135
Abdu, R. A., Garritano, D., & Culver, O. (1987). Acute gastric necrosis in anorexia nervosa and bulimia. Two case reports. Archives of Surgery, 122(7), 830-832. https://doi.org/10.1001/archsurg.1987.01400190096021
Abell, T. L., Malagelada, J. R., Lucas, A. R., Brown, M. L., Camilleri, M., Go, V. L., … Huse, D. M. (1987). Gastric electromechanical and neurohormonal function in anorexia nervosa. Gastroenterology, 93(5), 958-965. https://doi.org/10.1016/0016-5085(87)90557-9
Abraham, S., & Kellow, J. (2011). Exploring eating disorder quality of life and functional gastrointestinal disorders among eating disorder patients. Journal of Psychosomatic Research, 70(4), 372-377. https://doi.org/10.1016/j.jpsychores.2010.11.009
Abraham, S., Luscombe, G. M., & Kellow, J. E. (2012). Pelvic floor dysfunction predicts abdominal bloating and distension in eating disorder patients. Scandinavian Journal of Gastroenterology, 47(6), 625-631. http://dx.doi.org/10.3109/00365521.2012.661762.
Akgül, S., & Derman, O. (2014). A case of anorexia nervosa with multiple medical complications. The Turkish Journal of Pediatrics, 56(5), 553-556.
Albano, M. N., Costa Almeida, C., Louro, J. M., & Martinez, G. (2017). Increase body weight to treat superior mesenteric artery syndrome. BML Case Reports, 2017, 1-4. https://doi.org/10.1136/bcr-2017-219378
Backett, S. A. (1985). Acute pancreatitis and gastric dilatation in a patient with anorexia nervosa. Postgraduate Medical Journal, 61(711), 39-40. https://doi.org/10.1136/pgmj.61.711.39
Baeza-Velasco, C., van den Bossche, T., Grossin, D., & Hamonet, C. (2016). Difficulty eating and significant weight loss in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type. Eating and Weight Disorders, 21(2), 175-183. https://doi.org/10.1007/s40519-015-0232-x
Basso, M. S., Zanna, V., Panetta, F., Caramadre, A. M., Ferretti, F., Ottino, S., & Diamanti, A. (2013). Is the screening for celiac disease useful in anorexia nervosa? European Journal of Pediatrics, 172(2), 261-263. https://doi.org/10.1007/s00431-012-1864-8
Beck, R., Goldberg, E., Durie, P. R., & Levison, H. (1986). Elevated sweat chloride levels in anorexia nervosa. The Journal of Pediatrics, 108(2), 260-262. https://doi.org/10.1016/s0022-3476(86)80999-4
Benini, L., Todesco, T., Dalle Grave, R., Deiorio, F., Salandini, L., & Vantini, I. (2004). Gastric emptying in patients with restricting and binge/purging subtypes of anorexia nervosa. The American Journal of Gastroenterology, 99(8), 1448-1454. https://doi.org/10.1111/j.1572-0241.2004.30246.x
Benini, L., Todesco, T., Frulloni, L., Dalle Grave, R., Campagnola, P., Agugiaro, F., … Vantini, I. (2010). Esophageal motility and symptoms in restricting and binge-eating/purging anorexia. Digestive and Liver Disease, 42(11), 767-772. https://doi.org/10.1016/j.dld.2010.03.018
Benini, L., Todesco, T., Grave, R., & Vantini, I. (2001). Gastric, colonic and esophageal motility in anorexia. Relationship with symptoms, psychopathological distress and results of treatment. Gastroenterology (New York, N.Y. 1943), 120(5), A285. https://doi.org/10.1016/S0016-5085(01)81415-3
Bluemel, S., Menne, D., Milos, G., Goetze, O., Fried, M., Schwizer, W., … Steingoetter, A. (2017). Relationship of body weight with gastrointestinal motor and sensory function: Studies in anorexia nervosa and obesity. BMC Gastroenterology, 17(1), 4. https://doi.org/10.1186/s12876-016-0560-y
Bomba, M., Tremolizzo, L., Corbetta, F., Conti, E., Riva, A., & Nacinovich, R. (2015). PS-008 anorexia nervosa in adolescent girls and celiac disease serology. European Child & Adolescent Psychiatry, 24(Suppl 1), S1:S303.
Boyd, C., Abraham, S., & Kellow, J. (2005). Psychological features are important predictors of functional gastrointestinal disorders in patients with eating disorders. Scandinavian Journal of Gastroenterology, 40(8), 929-935. https://doi.org/10.1080/00365520510015836
Boyd, C., Abraham, S., & Kellow, J. (2010). Appearance and disappearance of functional gastrointestinal disorders in patients with eating disorders. Neurogastroenterology and Motility, 22(12), 1279-1283. https://doi.org/10.1111/j.1365-2982.2010.01576.x
Brook, G. K. (1977). Acute gastric dilatation in anorexia nervosa. British Medical Journal, 2(6085), 499-500. https://doi.org/10.1136/bmj.2.6085.499-a
Buchman, A. L., Ament, M. E., Weiner, M., Kodner, A., & Mayer, E. A. (1994). Reversal of megaduodenum and duodenal dysmotility associated with improvement in nutritional status in primary anorexia nervosa. Digestive Diseases and Sciences, 39(2), 433-440. https://doi.org/10.1007/bf02090220
Bulbena, A., Baeza-Velasco, C., Bulbena-Cabré, A., Pailhez, G., Critchley, H., Chopra, P., … Porges, S. (2017). Psychiatric and psychological aspects in the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 237-245. https://doi.org/10.1002/ajmg.c.31544
Chamay-Weber, C., Narring, F., & Michaud, P. A. (2005). Partial eating disorders among adolescents: A review. The Journal of Adolescent Health, 37(5), 417-427. https://doi.org/10.1016/j.jadohealth.2004.09.014
Chiarioni, G., Bassotti, G., Monsignori, A., Menegotti, M., Salandini, L., Di Matteo, G., … Whitehead, W. E. (2000). Anorectal dysfunction in constipated women with anorexia nervosa. Mayo Clinic Proceedings, 75(10), 1015-1019. https://doi.org/10.4065/75.10.1015
Chun, A. B., Sokol, M. S., Kaye, W. H., Hutson, W. R., & Wald, A. (1997). Colonic and anorectal function in constipated patients with anorexia nervosa. The American Journal of Gastroenterology, 92(10), 1879-1883.
Collins, A., Nolan, E., Hurley, M., D'Alton, A., & Hussey, S. (2018). Anorexia nervosa complicating pediatric Crohn disease-Case report and literature review. Frontiers in Pediatrics, 6, 1-3. https://doi.org/10.3389/fped.2018.00283
Conviser, J. H., Fisher, S. D., & McColley, S. A. (2018). Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review. The International Journal of Eating Disorders, 51(3), 187-213. https://doi.org/10.1002/eat.22831
Cortes, E., Singh, K., & Reid, W. M. (2003). Anorexia nervosa and pelvic floor dysfunction. International Urogynecology Journal and Pelvic Floor Dysfunction, 14(4), 254-255; discussion 255. https://doi.org/10.1007/s00192-003-1082-z
Cox, K. L., Cannon, R. A., Ament, M. E., Phillips, H. E., & Schaffer, C. B. (1983). Biochemical and ultrasonic abnormalities of the pancreas in anorexia nervosa. Digestive Diseases and Sciences, 28(3), 225-229. https://doi.org/10.1007/bf01295117
Cuntz, U., Frank, G., Lehnert, P., & Fichter, M. (2000). Interrelationships between the size of the pancreas and the weight of patients with eating disorders. The International Journal of Eating Disorders, 27(3), 297-303. https://doi.org/10.1002/(sici)1098-108x(200004)27:3<297::aid-eat6>3.0.co;2-6
de Silva, A. P., Molagoda, A., Fernando, P. L., & de Silva, H. J. (1998). The young woman who could not stop vomiting. Postgraduate Medical Journal, 74(877), 691-692. https://doi.org/10.1136/pgmj.74.877.691
Devitt, P. G., & Stamp, G. W. (1983). Acute clostridial enteritis-or pig-bel? Gut, 24(7), 678-679. https://doi.org/10.1136/gut.24.7.678
di Luca, A., Ricci, E., Grassi, V. M., Arena, V., & Oliva, A. (2019). An exceptional case of acute respiratory failure caused by intra-thoracic gastric perforation secondary to overeating. Journal of Forensic Sciences, 64(1), 292-294. https://doi.org/10.1111/1556-4029.13825
di Pascoli, L., Lion, A., Milazzo, D., & Caregaro, L. (2004). Acute liver damage in anorexia nervosa. The International Journal of Eating Disorders, 36(1), 114-117. https://doi.org/10.1002/eat.20002
Diamanti, A., Bracci, F., Gambarara, M., Ciofetta, G. C., Sabbi, T., Ponticelli, A., … Castro, M. (2003). Gastric electric activity assessed by electrogastrography and gastric emptying scintigraphy in adolescents with eating disorders. Journal of Pediatric Gastroenterology and Nutrition, 37(1), 35-41. https://doi.org/10.1097/00005176-200307000-00006
Docx, M. K. F., Verbeke, K., Simons, A., Weyler, J., Ramet, J., Mertens, L., & Veereman-Wauters, G. (2012). Delayed gastric emptying in anorexic adolescents measured with the 13C octanoic acid breath test. Food and Nutrition Sciences, 03(08), 1043-1047. https://doi.org/10.4236/fns.2012.38138
Drossman, D. (2016). Functional gastrointestinal disorders: History, pathophysiology, clinical features, and Rome IV. Gastroenterology, 150(6), 1262-1279.e1262. https://doi.org/10.1053/j.gastro.2016.02.032
Dreznik, Z., Vishne, T. H., Kristt, D., Alper, D., & Ramadan, E. (2001). Rectal prolapse: A possibly underrecognized complication of anorexia nervosa amenable to surgical correction. The International Journal of Psychiatry in Medicine, 31(3), 347-352. http://dx.doi.org/10.2190/3987-2n5a-fjdg-m89f
Dubois, A., Gross, H. A., Ebert, M. H., & Castell, D. O. (1979). Altered gastric emptying and secretion in primary anorexia nervosa. Gastroenterology, 77(2), 319-323.
Elbadaway, M. H. (1992). Chronic superior mesenteric artery syndrome in anorexia nervosa. The British Journal of Psychiatry, 160, 552-554. https://doi.org/10.1192/bjp.160.4.552
El Ghoch, M., Benini, L., Sgarbi, D., & Dalle Grave, R. (2016). Solitary rectal ulcer syndrome in a patient with anorexia nervosa: A case report. International Journal of Eating Disorders, 49(7), 731-735. http://dx.doi.org/10.1002/eat.22548
Eraslan, D., Ozturk, O., & Bor, S. (2009). Eating disorder symptoms improved by antireflux surgery: A case report with a six-year follow up. The Israel Journal of Psychiatry and Related Sciences, 46(3), 231-235.
Froese, A. P., Szmuilowicz, J., & Bailey, J. D. (1978). The superior-mesenteric-artery syndrome: Cause or complication of anorexia nervosa? Canadian Psychiatric Association Journal, 23(5), 325-327. https://doi.org/10.1177/070674377802300508
García Aroca, J., Alonso Calderón, J. L., García Redondo, C., & Rollán Villamarín, V. (2001). Anorexia nervosa or somatic disease. Cirugía Pediátrica, 14(3), 98-102.
Goh, M., Olver, J., Huang, C., Millard, M., & O'Callaghan, C. (2013). Prevalence and familial patterns of gastrointestinal symptoms, joint hypermobility and diurnal blood pressure variations in patients with anorexia nervosa. Journal of Eating Disorders, 1(Suppl 1), O45. https://doi.org/10.1186/2050-2974-1-s1-o45
Gryboski, J., Hillemeier, C., Kocoshis, S., Anyan, W., & Seashore, J. S. (1980). Refeeding pancreatitis in malnourished children. The Journal of Pediatrics, 97(3), 441-443. https://doi.org/10.1016/s0022-3476(80)80201-0
Gwee, K., Teh, A., & Huang, C. (2010). Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa. Australasian Psychiatry, 18(6), 523-526. https://doi.org/10.3109/10398562.2010.498885
Harer, K. N., Jagielski, C. H., Riehl, M. E., & Chey, W. D. (2019). 272-Avoidant/restrictive food intake disorder among adult gastroenterology behavioral health patients: Demographic and clinical characteristics. Gastroenterology, 156(6), S-53. https://doi.org/10.1016/s0016-5085(19)36916-1
Hedman, A., Breithaupt, L., Hubel, C., Thornton, L. M., Tillander, A., Norring, C., … Bulik, C. M. (2019). Bidirectional relationship between eating disorders and autoimmune diseases. Journal of Child Psychology and Psychiatry, 60(7), 803-812. https://doi.org/10.1111/jcpp.12958
Hershenfeld, S. A., Wasim, S., McNiven, V., Parikh, M., Majewski, P., Faghfoury, H., & So, J. (2016). Psychiatric disorders in Ehlers-Danlos syndrome are frequent, diverse and strongly associated with pain. Rheumatology International, 36(3), 341-348. https://doi.org/10.1007/s00296-015-3375-1
Heruc, G. A., Little, T. J., Kohn, M. R., Madden, S., Clarke, S. D., Horowitz, M., & Feinle-Bisset, C. (2018). Effects of starvation and short-term refeeding on gastric emptying and postprandial blood glucose regulation in adolescent girls with anorexia nervosa. American Journal of Physiology. Endocrinology and Metabolism, 315(4), E565-E573. https://doi.org/10.1152/ajpendo.00149.2018
Hirakawa, M., Okada, T., Iida, M., Tamai, H., Kobayashi, N., Nakagawa, T., & Fujishima, M. (1990). Small bowel transit time measured by hydrogen breath test in patients with anorexia nervosa. Digestive Diseases and Sciences, 35(6), 733-736. https://doi.org/10.1007/bf01540176
Holmes, S. R. M., Sabel, A. L., Gaudiani, J. L., Gudridge, T. A., Brinton, J. T., & Mehler, P. S. (2016). Prevalence and management of oropharyngeal dysphagia in patients with severe anorexia nervosa: A large retrospective review. International Journal of Eating Disorders, 49(2), 161-168. https://doi.org/10.1002/eat.22441
Holt, S., Ford, M. J., Grant, S., & Heading, R. C. (1981). Abnormal gastric emptying in primary anorexia nervosa. The British Journal of Psychiatry, 139, 550-552. https://doi.org/10.1192/bjp.139.6.550
Holtkamp, K., Mogharrebi, R., Hanisch, C., Schumpelick, V., & Herpertz-Dahlmann, B. (2002). Gastric dilatation in a girl with former obesity and atypical anorexia nervosa. The International Journal of Eating Disorders, 32(3), 372-376. https://doi.org/10.1002/eat.10098
Horsley, T., Dingwall, O., & Sampson, M. (2011). Checking reference lists to find additional studies for systematic reviews. Cochrane Database of Systematic Reviews, 2011(8), Mr000026. https://doi.org/10.1002/14651858.MR000026.pub2
Humphries, L. L., Adams, L. J., Eckfeldt, J. H., Levitt, M. D., & McClain, C. J. (1987). Hyperamylasemia in patients with eating disorders. Annals of Internal Medicine, 106(1), 50-52. https://doi.org/10.7326/0003-4819-106-1-50
Hutson, W. R., & Wald, A. (1990). Gastric emptying in patients with bulimia nervosa and anorexia nervosa. The American Journal of Gastroenterology, 85(1), 41-46.
Jennings, K. P., & Klidjian, A. M. (1974). Acute gastric dilatation in anorexia nervosa. British Medical Journal, 2(5917), 477-478. https://doi.org/10.1136/bmj.2.5917.477
Johnson, B. M., & Paladugu, G. (2019). Superior mesenteric artery syndrome secondary to anorexia nervosa and methamphetamine use. Cureus, 11(11), e6121. https://doi.org/10.7759/cureus.6121
Jordaan, G. P., Muller, A., Greeff, M., & Stein, D. J. (2000). Eating disorder and superior mesenteric artery syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 39(10), 1211. https://doi.org/10.1097/00004583-200010000-00005
Kalouche, I., Léturgie, C., Tronc, F., Bokobza, B., Michot, F., Pons, P., & Ménard, G. (1991). The superior mesenteric artery syndrome. Apropos of a case and review of the literature. Annales de Chirurgie, 45(7), 609-612.
Kaltsa, M., Garoufi, A., Tsitsika, A., Tsirogianni, A., Papasteriades, C., & Kossiva, L. (2015). Patients with eating disorders showed no signs of coeliac disease before and after nutritional intervention. Acta Paediatrica, 104(7), e319-e323. https://doi.org/10.1111/apa.12985
Kaluski, D. N., Natamba, B. K., Goldsmith, R., Shimony, T., & Berry, E. M. (2008). Determinants of disordered eating behaviors among Israeli adolescent girls. Eating Disorders, 16(2), 146-159. https://doi.org/10.1080/10640260801887303
Kamal, N., Chami, T., Andersen, A., Rosell, F. A., Schuster, M. M., & Whitehead, W. E. (1991). Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. Gastroenterology, 101(5), 1320-1324. https://doi.org/10.1016/0016-5085(91)90083-w
Karwautz, A., Wagner, G., Berger, G., Sinnreich, U., Grylli, V., & Huber, W. D. (2008). Eating pathology in adolescents with celiac disease. Psychosomatics, 49(5), 399-406. https://doi.org/10.1176/appi.psy.49.5.399
Keane, F. B., Fennell, J. S., & Tomkin, G. H. (1978). Acute pancreatitis, acute gastric dilation and duodenal ileus following refeeding in anorexia nervosa. Irish Journal of Medical Science, 147(5), 191-192. https://doi.org/10.1007/bf02939399
Kessler, U., Rekkedal, G. A., Ro, O., Berentsen, B., Steinsvik, E. K., Lied, G. A., & Danielsen, Y. (2020). Association between gastrointestinal complaints and psychopathology in patients with anorexia nervosa. The International Journal of Eating Disorders, 53(5), 532-536. https://doi.org/10.1002/eat.23243
Kiesow, K., Shahid, N., Park, C. C., Weaver, L., Lantzouni, E., & Peebles, R. (2018). Pancreatic enzyme elevation in adolescents with eating disorders. Journal of Adolescent Health, 62(2), S101. https://doi.org/10.1016/j.jadohealth.2017.11.204
Kim, T., Kim, H. U., & Song, H. J. (2012). A case of gastric emphysema in anorexia nervosa presenting as acute gastric distension. The Korean Journal of Gastroenterology, 60(5), 315-319. https://doi.org/10.4166/kjg.2012.60.5.315
Kiss, A., Wiesnagrotzki, S., Abatzi, T. A., Meryn, S., Haubenstock, A., & Base, W. (1989). Upper gastrointestinal endoscopy findings in patients with long-standing bulimia nervosa. Gastrointestinal Endoscopy, 35(6), 516-518. https://doi.org/10.1016/s0016-5107(89)72901-1
Kuyumcu, S., Goetze, O., Boesiger, P., Milos, G., Fried, M., Menne, D., … Steingoetter, A. (2012). Sa1431 anorexia nervosa patients have dyspeptic symptoms, delayed gastric emptying and reduced gastric contractile activity. Gastroenterology, 142(5), S-304. https://doi.org/10.1016/s0016-5085(12)61138-x
Kuyumcu, S., Goetze, O., Fox, M. R., Menne, D., Boesiger, P., Milos, G., … Steingoetter, A. (2013). Mo2099 weight gain in anorexia nervosa patients is associated with normalization of gastric contractile activity and visceral sensation but does not impact on emptying rate and dyspeptic symptoms. Gastroenterology, 144(5), S-742. https://doi.org/10.1016/s0016-5085(13)62751-1
Kuyumcu, S., Menne, D., Goetze, O., Boesiger, P., Fried, M., Milos, G., … Steingoetter, A. (2012). Sa1423 visceral perception in anorexia nervosa patients and its relation to actual stomach volumes. Gastroenterology, 142(5), S-302. https://doi.org/10.1016/s0016-5085(12)61130-5
Lal, K., Slaby, I., & Chiesa, D. (2019). 2786 abdominal pain in a patient with anorexia nervosa. The American Journal of Gastroenterology, 114(1), S1539-S1539. https://doi.org/10.14309/01.ajg.0000600676.72636.a0
Lee, M., & Strand, M. (2018). Ehlers-Danlos syndrome in a young woman with anorexia nervosa and complex somatic symptoms. The International Journal of Eating Disorders, 51(3), 281-284. https://doi.org/10.1002/eat.22815
Leffler, D. A., Dennis, M., Edwards George, J. B., & Kelly, C. P. (2007). The interaction between eating disorders and celiac disease: An exploration of 10 cases. European Journal of Gastroenterology & Hepatology, 19(3), 251-255. https://doi.org/10.1097/MEG.0b013e328012db37
Lo, D. Y., Yen, J. L., & Jones, M. P. (2004). Massive gastric dilation and necrosis in anorexia nervosa: Cause or effect? Nutrition in Clinical Practice, 19(4), 409-412. https://doi.org/10.1177/0115426504019004409
Mallett, P., & Murch, S. (1990). Anorexia nervosa complicating inflammatory bowel disease. Archives of Disease in Childhood, 65(3), 298-300. https://doi.org/10.1136/adc.65.3.298
Marild, K., Stordal, K., Bulik, C. M., Rewers, M., Ekbom, A., Liu, E., & Ludvigsson, J. F. (2017). Celiac disease and anorexia nervosa: A Nationwide study. Pediatrics, 139(5), e20164367. https://doi.org/10.1542/peds.2016-4367
Martinez-Olmos, M. A., Peino, R., Prieto-Tenreiro, A., Lage, M., Nieto, L., Lord, T., … Casanueva, F. F. (2013). Intestinal absorption and pancreatic function are preserved in anorexia nervosa patients in both a severely malnourished state and after recovery. European Eating Disorders Review, 21(3), 247-251. https://doi.org/10.1002/erv.2223
Marjoux, S., Bennadji, B., De Parades, V., Mosnier, H., Atienza, P., Barth, X., … Damon, H. (2012). Mo1059 rectal prolapse and anorexia nervosa: About 24 cases. Gastroenterology, 142(5), S-584. http://dx.doi.org/10.1016/s0016-5085(12)62240-9
Masaki, S., Watanabe, T., Minaga, K., Kamata, K., Komeda, Y., Kimura, M., & Kudo, M. (2020). Possible involvement of autophagy in esophageal ulcers in anorexia nervosa. Clinical Journal of Gastroenterology, 13(4), 473-476. https://doi.org/10.1007/s12328-019-01089-0
Mascolo, M., Dee, E., Townsend, R., Brinton, J. T., & Mehler, P. S. (2015). Severe gastric dilatation due to superior mesenteric artery syndrome in anorexia nervosa. The International Journal of Eating Disorders, 48(5), 532-534. https://doi.org/10.1002/eat.22385
Mathevon, T., Rougier, C., Ducher, E., Pic, D., Garcier, J. M., & Schmidt, J. (2004). Acute abdominal dilatation, a serious complication in the case of anorexia nervosa. Presse Médicale, 33(9 Pt 1), 601-603. https://doi.org/10.1016/s0755-4982(04)98684-8
Mattheus, H. K., Wagner, C., Becker, K., Bühren, K., Correll, C. U., Egberts, K. M., … von Gontard, A. (2020). Incontinence and constipation in adolescent patients with anorexia nervosa-Results of a multicenter study from a German web-based registry for children and adolescents with anorexia nervosa. The International Journal of Eating Disorders, 53(2), 219-228. https://doi.org/10.1002/eat.23182
McCallum, R. W., Grill, B. B., Lange, R., Planky, M., Glass, E. E., & Greenfeld, D. G. (1985). Definition of a gastric emptying abnormality in patients with anorexia nervosa. Digestive Diseases and Sciences, 30(8), 713-722. https://doi.org/10.1007/bf01320484
Mearelli, F., Degrassi, F., Occhipinti, A. A., Casarsa, C., de Manzini, N., & Biolo, G. (2014). Pinched: Superior mesenteric artery syndrome. The American Journal of Medicine, 127(5), 393-394. https://doi.org/10.1016/j.amjmed.2014.01.008
Metcalfe-Gibson, C. (1978). Anorexia nervosa and Crohn's disease. The British Journal of Surgery, 65(4), 231-233. https://doi.org/10.1002/bjs.1800650405
Miles, S. C., Robinson, P. D., & Miles, J. L. (2007). Ehlers-Danlos syndrome and anorexia nervosa: A dangerous combination? Pediatric Dermatology, 24(3), E1-E4. https://doi.org/10.1111/j.1525-1470.2007.00382.x
Mitchell, N., & Norris, M. L. (2013). Rectal prolapse associated with anorexia nervosa: a case report and review of the literature. Journal of Eating Disorders, 1(1). http://dx.doi.org/10.1186/2050-2974-1-39
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
Monteleone, P., Carratu, R., Carteni, M., Generoso, M., Lamberti, M., Magistris, L. D., … Maj, M. (2004). Intestinal permeability is decreased in anorexia nervosa. Molecular Psychiatry, 9(1), 76-80. https://doi.org/10.1038/sj.mp.4001374
Moreno, M. A., & Smith, M. S. (2006). Anorexia in a 14-year-old girl: Why won't she eat? The Journal of Adolescent Health, 39(6), 936-938. https://doi.org/10.1016/j.jadohealth.2006.05.017
Moriai, T., Kashiwaya, T., Matsui, T., Okada, M., Sato, T., Shibata, T., … Makino, I. (1998). Pancreatic pseudocyst associated with eating disorder. Journal of Gastroenterology, 33(3), 443-446. https://doi.org/10.1007/s005350050111
Morris, L. G., Stephenson, K. E., Herring, S., & Marti, J. L. (2004). Recurrent acute pancreatitis in anorexia and bulimia. Journal of the Pancreas: JOP, 5(4), 231-234.
Morse, J. L., & Safdar, B. (2010). Acute tension pneumothorax and tension pneumoperitoneum in a patient with anorexia nervosa. The Journal of Emergency Medicine, 38(3), e13-e16. https://doi.org/10.1016/j.jemermed.2007.07.002
Mostowy, J., Monten, C., Gudjonsdottir, A. H., Arnell, H., Browaldh, L., Nilsson, S., … Torinsson Naluai, A. (2016). Shared genetic factors involved in celiac disease, type 2 diabetes and anorexia nervosa suggest common molecular pathways for chronic diseases. PLoS One, 11(8), e0159593. https://doi.org/10.1371/journal.pone.0159593
Murray, H. B., Bailey, A. P., Keshishian, A. C., Silvernale, C. J., Staller, K., Eddy, K. T., … Kuo, B. (2020). Prevalence and characteristics of avoidant/restrictive food intake disorder in adult neurogastroenterology patients. Clinical Gastroenterology and Hepatology, 18(9), 1995-2002 e1991. https://doi.org/10.1016/j.cgh.2019.10.030
Murray, H. B., Jehangir, A., Silvernale, C. J., Kuo, B., & Parkman, H. P. (2019). Mo1611-Symptoms of avoidant/restrictive food intake disorder are frequent in patients presenting to gastroenterologists for symptoms of gastroparesis. Gastroenterology (New York, N.Y. 1943), 156(6), S-800-S-801. https://doi.org/10.1016/S0016-5085(19)38955-3
Nacinovich, R., Tremolizzo, L., Corbetta, F., Conti, E., Neri, F., & Bomba, M. (2017). Anorexia nervosa of the restrictive type and celiac disease in adolescence. Neuropsychiatric Disease and Treatment, 13, 1211-1214. https://doi.org/10.2147/NDT.S124168
Nakao, A., Isozaki, H., Iwagaki, H., Kanagawa, T., Takakura, N., & Tanaka, N. (2000). Gastric perforation caused by a bulimic attack in an anorexia nervosa patient: Report of a case. Surgery Today, 30(5), 435-437. https://doi.org/10.1007/s005950050618
Ochi, M., Tominaga, K., Iketani, T., Kadouchi, K., Tanigawa, T., Shiba, M., … Arakawa, T. (2008). Perfectionism underlying psychological background correlated with the symptoms of functional dyspepsia. Journal of Gastroenterology, 43(9), 699-704. https://doi.org/10.1007/s00535-008-2210-9
Ogawa, A., Mizuta, I., Fukunaga, T., Takeuchi, N., Honaga, E., Sugita, Y., … Takeda, M. (2004). Electrogastrography abnormality in eating disorders. Psychiatry and Clinical Neurosciences, 58(3), 300-310. https://doi.org/10.1111/j.1440-1819.2004.01236.x
Osegueda de Rodriguez, E. J., Hernandez-Villegas, A. C., Serralde-Zuniga, A. E., & Reyes-Ramirez, A. (2017). The two sides of superior mesenteric artery syndrome treatment: Conservative or surgical management? Nutricion Hospitalaria, 34(4), 997-1000. https://doi.org/10.20960/nh.1006
Pacciardi, B., Cargioli, C., & Mauri, M. (2015). Barrett's esophagus in anorexia nervosa: A case report. The International Journal of Eating Disorders, 48(1), 147-150. https://doi.org/10.1002/eat.22288
Park, J. H., Lee, T. H., Cheon, S. L., Sun, J. H., Choi, I. K., Kim, Y. S., … Kang, Y. W. (2009). Severe acute liver and pancreas damage in anorexia nervosa. The Korean Journal of Gastroenterology, 54(4), 257-260. https://doi.org/10.4166/kjg.2009.54.4.257
Patcharatrakul, T., & Gonlachanvit, S. (2011). Outcome of biofeedback therapy in dyssynergic defecation patients with and without irritable bowel syndrome. Journal of Clinical Gastroenterology, 45(7), 593-598. http://dx.doi.org/10.1097/mcg.0b013e31820c6001
Pentlow, B. D., & Dent, R. G. (1981). Acute vascular compression of the duodenum in anorexia nervosa. The British Journal of Surgery, 68(9), 665-666. https://doi.org/10.1002/bjs.1800680918
Perez, M. E., Coley, B., Crandall, W., Di Lorenzo, C., & Bravender, T. (2013). Effect of nutritional rehabilitation on gastric motility and somatization in adolescents with anorexia. The Journal of Pediatrics, 163(3), 867-872 e861. https://doi.org/10.1016/j.jpeds.2013.03.011
Perkins, S. J., Keville, S., Schmidt, U., & Chalder, T. (2005). Eating disorders and irritable bowel syndrome: Is there a link? Journal of Psychosomatic Research, 59(2), 57-64. https://doi.org/10.1016/j.jpsychores.2004.04.375
Porcelli, P., Leandro, G., & de Carne, M. (1998). Functional gastrointestinal disorders and eating disorders. Relevance of the association in clinical management. Scandinavian Journal of Gastroenterology, 33(6), 577-582. https://doi.org/10.1080/00365529850171819
Pynnönen, P., Isometsä, E., Aalberg, V., Verkasalo, M., & Savilahti, E. (2002). Is coeliac disease prevalent among adolescent psychiatric patients? Acta Paediatrica, 91(6), 657-659. https://doi.org/10.1080/080352502760069061
Raevuori, A., Haukka, J., Vaarala, O., Suvisaari, J. M., Gissler, M., Grainger, M., … Suokas, J. T. (2014). The increased risk for autoimmune diseases in patients with eating disorders. PLoS One, 9(8), e104845. https://doi.org/10.1371/journal.pone.0104845
Rajdev, S., Briscoe, N., Pigott, A., Jones, M., & Hall, C. (2014). G84(P) superior mesenteric artery (SMA) syndrome: An unusual cause of proximal intestinal obstruction. Archives of Disease in Childhood, 99(Suppl 1), A36. https://doi.org/10.1136/archdischild-2014-306237.84
Rao, S. S. C., Tuteja, A. K., Vellema, T., Kempf, J., & Stessman, M. (2004). Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. Journal of Clinical Gastroenterology, 38(8), 680-685. http://dx.doi.org/10.1097/01.mcg.0000135929.78074.8c.
Ravelli, A. M., Helps, B. A., Devane, S. P., Lask, B. D., & Milla, P. J. (1993). Normal gastric antral myoelectrical activity in early onset anorexia nervosa. Archives of Disease in Childhood, 69(3), 342-346. https://doi.org/10.1136/adc.69.3.342
Ravneet, D., & Paradiso, S. (2008). Anorexia nervosa and mercury toxicity. American Journal of Psychiatry, 165(11), 1489-1489. http://dx.doi.org/10.1176/appi.ajp.2008.08020233
Rebollo Román, Á., Barrera Martín, A., Alcántara-Laguna, M. D., Iglesias-Flores, E., Cañada-Sanz, E., Padillo-Cuenca, J. C., … Calañas-Continente, A. (2018). Non-oropharyngeal dysphagia with frequent emergency room attendance. Nutricion Hospitalaria, 35(4), 996-998. https://doi.org/10.20960/nh.1933
Rehman, A., Saeed, A., Shaukat, T., Jamil, K., Zaidi, A. H., & Abdullah, K. (2011). Wilkie's syndrome. Journal of the College of Physicians and Surgeons-Pakistan, 21(1), 43-45.
Ricca, V., Mannucci, E., Calabrò, A., Bernardo, M. D., Cabras, P. L., & Rotella, C. M. (2000). Anorexia nervosa and celiac disease: Two case reports. The International Journal of Eating Disorders, 27(1), 119-122. https://doi.org/10.1002/(sici)1098-108x(200001)27:1<119::aid-eat16>3.0.co;2-r
Rigaud, D., Bedig, G., Merrouche, M., Vulpillat, M., Bonfils, S., & Apfelbaum, M. (1988). Delayed gastric emptying in anorexia nervosa is improved by completion of a renutrition program. Digestive Diseases and Sciences, 33(8), 919-925. https://doi.org/10.1007/bf01535985
Robinson, P. H. (1989). Perceptivity and paraceptivity during measurement of gastric emptying in anorexia and bulimia nervosa. The British Journal of Psychiatry, 154, 400-405. https://doi.org/10.1192/bjp.154.3.400
Robson, J., Laborda, T., Fitzgerald, S., Andersen, J., Peterson, K., O'Gorman, M., … Bennett-Murphy, L. (2019). Avoidant/restrictive food intake disorder in diet-treated children with eosinophilic esophagitis. Journal of Pediatric Gastroenterology and Nutrition, 69(1), 57-60. https://doi.org/10.1097/mpg.0000000000002323
Saldanha, N. E., Weiselberg, E. C., & Fisher, M. (2016). Screening for celiac disease in patients with eating disorders. International Journal of Adolescent Medicine and Health, 30(1), S20-S36. https://doi.org/10.1515/ijamh-2016-0007
Salvioli, B., Pellicciari, A., Iero, L., Di Pietro, E., Moscano, F., Gualandi, S., … Franzoni, E. (2013). Audit of digestive complaints and psychopathological traits in patients with eating disorders: A prospective study. Digestive and Liver Disease, 45(8), 639-644. https://doi.org/10.1016/j.dld.2013.02.022
Santonicola, A., Siniscalchi, M., Capone, P., Gallotta, S., Ciacci, C., & Iovino, P. (2012). Prevalence of functional dyspepsia and its subgroups in patients with eating disorders. World Journal of Gastroenterology, 18(32), 4379-4385. https://doi.org/10.3748/wjg.v18.i32.4379
Satherley, R. M., Higgs, S., & Howard, R. (2017). Disordered eating patterns in coeliac disease: A framework analysis. Journal of Human Nutrition and Dietetics, 30(6), 724-736. https://doi.org/10.1111/jhn.12475
Saul, S. H., Dekker, A., & Watson, C. G. (1981). Acute gastric dilatation with infarction and perforation. Report of fatal outcome in patient with anorexia nervosa. Gut, 22(11), 978-983. https://doi.org/10.1136/gut.22.11.978
Schoettle, U. C. (1979). Pancreatitis: A complication, a concomitant, or a cause of an anorexia nervosalike syndrome. Journal of the American Academy of Child Psychiatry, 18(2), 384-390. https://doi.org/10.1016/s0002-7138(09)61050-5
Sileri, P., Franceschilli, L., de Lorenzo, A., Mezzani, B., Todisco, P., Giorgi, F., … Jacoangeli, F. (2014). Defecatory disorders in anorexia nervosa: A clinical study. Techniques in Coloproctology, 18(5), 439-444. https://doi.org/10.1007/s10151-013-1068-x
Silvernale, C. J., Kuo, B., & Staller, K. (2020). Sa1678 Pelvic floor prolapse associated with gi-specific healthcare utilization and anorexia nervosa in an eating disorder patient cohort. Gastroenterology, 158(6). http://dx.doi.org/10.1016/s0016-5085(20)31642-5
Sinagra, E., Raimondo, D., Albano, D., Guarnotta, V., Blasco, M., Testai, S., … Midiri, M. (2018). Superior mesenteric artery syndrome: Clinical, endoscopic, and radiological findings. Gastroenterology Research and Practice, 2018, 1937416. https://doi.org/10.1155/2018/1937416
Sinicina, I., Pankratz, H., Buttner, A., & Mall, G. (2005). Death due to neurogenic shock following gastric rupture in an anorexia nervosa patient. Forensic Science International, 155(1), 7-12. https://doi.org/10.1016/j.forsciint.2004.10.021
Solmi, M., Santonastaso, P., Caccaro, R., & Favaro, A. (2013). A case of anorexia nervosa with comorbid Crohn's disease: Beneficial effects of anti-TNF-alpha therapy? The International Journal of Eating Disorders, 46(6), 639-641. https://doi.org/10.1002/eat.22153
Sours, J. A., & Vorhaus, L. J. (1981). Superior mesenteric artery syndrome in anorexia nervosa: A case report. The American Journal of Psychiatry, 138(4), 519-520. https://doi.org/10.1176/ajp.138.4.519
Sreenivasan, U. (1984). Anorexia nervosa associated with energy-wasting disorders. Canadian Medical Association Journal, 130(1), 45-46.
Stacher, G., Kiss, A., Wiesnagrotzki, S., Bergmann, H., Höbart, J., & Schneider, C. (1986). Oesophageal and gastric motility disorders in patients categorised as having primary anorexia nervosa. Gut, 27(10), 1120-1126. https://doi.org/10.1136/gut.27.10.1120
Stheneur, C., Rey, C., Pariente, D., & Alvin, P. (1995). Acute gastric dilatation with superior mesenteric artery syndrome in a young girl with anorexia nervosa. Archives de Pédiatrie, 2(10), 973-976. https://doi.org/10.1016/0929-693x(96)89893-9
Szmukler, G. I., Young, G. P., Lichtenstein, M., & Andrews, J. T. (1990). A serial study of gastric emptying in anorexia nervosa and bulimia. Australian and New Zealand Journal of Medicine, 20(3), 220-225. https://doi.org/10.1111/j.1445-5994.1990.tb01023.x
Takimoto, Y., Yoshiuchi, K., Shimodaira, S., & Akabayashi, A. (2014). Diamine oxidase activity levels in anorexia nervosa. The International Journal of Eating Disorders, 47(2), 203-205. https://doi.org/10.1002/eat.22202
Tjeerdsma, H. C., Smout, A. J. P. M., & Akkermans, L. M. A. (1993). Voluntary suppression of defecation delays gastric emptying. Digestive Diseases and Sciences, 38(5), 832-836. http://dx.doi.org/10.1007/bf01295908
Tweed-Kent, A. M., Fagenholz, P. J., & Alam, H. B. (2010). Acute gastric dilatation in a patient with anorexia nervosa binge/purge subtype. Journal of Emergencies, Trauma, and Shock, 3(4), 403-405. https://doi.org/10.4103/0974-2700.70774
Tylee, D. S., Sun, J., Hess, J. L., Tahir, M. A., Sharma, E., Malik, R., … Glatt, S. J. (2018). Genetic correlations among psychiatric and immune-related phenotypes based on genome-wide association data. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics, 177(7), 641-657. https://doi.org/10.1002/ajmg.b.32652
van Eetvelde, E., Verfaillie, L., van de Winkel, N., & Hubloue, I. (2014). Acute gastric dilatation causing acute limb ischemia in an anorexia nervosa patient. The Journal of Emergency Medicine, 46(5), e141-e143. https://doi.org/10.1016/j.jemermed.2013.11.093
Verhoef, P. A., & Rampal, A. (2009). Unique challenges for appropriate management of a 16-year-old girl with superior mesenteric artery syndrome as a result of anorexia nervosa: A case report. Journal of Medical Case Reports, 3, 127. https://doi.org/10.1186/1752-1947-3-127
Waldholtz, B. D., & Andersen, A. E. (1990). Gastrointestinal symptoms in anorexia nervosa. A prospective study. Gastroenterology, 98(6), 1415-1419. https://doi.org/10.1016/0016-5085(90)91070-m
Watanabe, S., Terazawa, K., Asari, M., Matsubara, K., Shiono, H., & Shimizu, K. (2008). An autopsy case of sudden death due to acute gastric dilatation without rupture. Forensic Science International, 180(2-3), e6-e10. https://doi.org/10.1016/j.forsciint.2008.07.005
Watters, A., Gibson, D., Dee, E., Mascolo, M., & Mehler, P. S. (2020). Superior mesenteric artery syndrome in severe anorexia nervosa: A case series. Clinical Case Reports, 8(1), 185-189. https://doi.org/10.1002/ccr3.2577
Welch, E., Ghaderi, A., & Swenne, I. (2015). A comparison of clinical characteristics between adolescent males and females with eating disorders. BMC Psychiatry, 15, 45. https://doi.org/10.1186/s12888-015-0419-8
Werlang, M. E., Sim, L. A., Lebow, J. R., Farraye, F. A., & Kroner, P. T. (2020). Sa1798 anorexia nervosa is associated with worse outcomes in hospitalized patients with inflammatory bowel disease. Gastroenterology, 158(6), S-428. https://doi.org/10.1016/s0016-5085(20)31758-3
Wesson, R. N., Sparaco, A., & Smith, M. D. (2008). Chronic pancreatitis in a patient with malnutrition due to anorexia nervosa. Journal of the Pancreas: JOP, 9(3), 327-331.
Wiklund, C. A., Kuja-Halkola, R., Thornton, L. M., Hubel, C., Leppa, V., & Bulik, C. M. (2019). Prolonged constipation and diarrhea in childhood and disordered eating in adolescence. Journal of Psychosomatic Research, 126, 109797. https://doi.org/10.1016/j.jpsychores.2019.109797
Winstead, N. S., & Willard, S. G. (2006). Gastrointestinal complaints in patients with eating disorders. Journal of Clinical Gastroenterology, 40(8), 678-682. https://doi.org/10.1097/00004836-200609000-00003
Wotton, C. J., James, A., & Goldacre, M. J. (2016). Coexistence of eating disorders and autoimmune diseases: Record linkage cohort study, UK. The International Journal of Eating Disorders, 49(7), 663-672. https://doi.org/10.1002/eat.22544
Yao, S. Y., Mikami, R., & Mikami, S. (2015). Minimally invasive surgery for superior mesenteric artery syndrome: A case report. World Journal of Gastroenterology, 21(45), 12970-12975. https://doi.org/10.3748/wjg.v21.i45.12970
Zarate, N., Farmer, A. D., Grahame, R., Mohammed, S. D., Knowles, C. H., Scott, S. M., & Aziz, Q. (2010). Unexplained gastrointestinal symptoms and joint hypermobility: is connective tissue the missing link?. Neurogastroenterology & Motility, 22(3), 252-278. http://dx.doi.org/10.1111/j.1365-2982.2009.01421.x
Zysk, W., Glabska, D., & Guzek, D. (2019). Food Neophobia in celiac disease and other gluten-free diet individuals. Nutrients, 11(8), 1-15. https://doi.org/10.3390/nu11081762