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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH, USA. maria.perez@atlantichealth.org.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Perez
authors.forename: Brian
authors.initials: B
authors.lastname: Coley
authors.forename: Wallace
authors.initials: W
authors.lastname: Crandall
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.forename: Terrill
authors.initials: T
authors.lastname: Bravender
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology / Q000523:psychology; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D011446:Prospective Studies; D011581:Psychological Tests; D057566:Self Report; D016037:Single-Blind Method; D013001:Somatoform Disorders / Q000175:diagnosis / Q000209:etiology*; D013270:Stomach / Q000000981:diagnostic imaging / Q000503:physiopathology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: AN; Anorexia nervosa; Baseline/initial testing; CSI; Children's Somatization Inventory; FGID; Follow-up testing; Functional gastrointestinal disorder; QPGS-RIII; Questionnaire on Pediatric Gastrointestinal Symptoms–Rome III version; RGV; Residual gastric volume; SCARED; Screen for Child Anxiety-Related Emotional Disorders; T1; T2