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Gut Function in Anorexia Nervosa and Bulimia Nervosa

This review is first a critical evaluation of the data published on the function of the gastrointestinal tract in patients with anorexia nervosa and bulimia nervosa (1) and, second, it aims at providing evidence-based guidance for clinicians. The impact of these two eating disorders on the organs of the digestive tract and the treatment strategies for overcoming them have been reviewed previously (2–10). The present article supplementing and updating these papers is based on a personal knowledge of the literature and publications dating back to 1966 identified using the Medline database. The search terms were anorexia nervosa, bulimia nervosa, appetite, taste, salivary glands, salivation, oesophagus, oesophageal motor function/motility, oesophagitis, reflux, dysphagia, heartburn, chest pain, binge eating, bingeing, vomiting, regurgitation, aspiration, gastric motor function/motility, gastric emptying, gastroparesis, fullness, bloating, epigastric pain, dilatation, distension, rupture, perforation, intestinal motor activity/motility, intestinal transport/transit, orocaecal transport/transit, colonic motor activity/motility, colonic transport/transit, constipation, purging, laxative, diarrhoea, anorectal, pancreas, malnutrition, metabolism, electrolyte, neuroendocrine, hormone, peptide, cholecystokinin, bombesin, insulin, glucagon, leptin, prolactin, neuropeptide Y, peptide YY, growth hormone, growth-hormone-releasing hormone, ghrelin, cortisol, adrenocorticotropic hormone, corticotropin-releasing hormone, thyroxine, thyroid-stimulating hormone, thyrotropin, motilin, serotonin, 5-hydroxytryptamine, gonadotropin, luteinizing hormone, follicle stimulating hormone, oestrogen, sex-hormone-binding globulin, neuropathy, myopathy, symptoms, psychiatric disorder, affective disorder, personality, genetic, twin, metoclopramide, domperidone, cisapride, erythromycin, incidence, prevalence and mortality. The searches were last updated on 29 November 2002. All the citations identified were pulled and screened for inclusion, and their references were reviewed for additional articles missed in the database search. Data in abstract form were included only if published not prior to 1999.