Eating disorder or disordered eating: undiagnosed inflammatory bowel disease mimicking eating disorder

2018 ◽  
Vol 104 (10) ◽  
pp. 1004-1006
Author(s):  
Rachel Elizabeth Harris ◽  
Rachel Tayler ◽  
Richard K Russell
Keyword(s):  
Inflammatory Bowel Disease ◽  
Eating Disorder ◽  
Disordered Eating ◽  
Bowel Disease ◽  
Eating Habits ◽  
Delayed Diagnosis ◽  
Important Differential Diagnosis ◽  
Gi Symptoms ◽  
Incorrect Diagnosis ◽  
Inflammatory Bowel

We describe the case of a patient with ongoing weight loss, low mood and previously undisclosed gastrointestinal (GI) symptoms initially diagnosed with an eating disorder and subsequently diagnosed with ulcerative colitis over a year following initial presentation. This patient exhibited disordered eating secondary to the worsening symptoms of undiagnosed inflammatory bowel disease (IBD) and had altered her eating habits to reduce the diarrhoea and rectal bleeding she was experiencing, contributing to significant weight loss.The implications of a delayed diagnosis of IBD or incorrect diagnosis of eating disorder are severe both physically and psychologically. We discuss factors in the assessment of patients which may raise suspicion of organic GI disease such as IBD—an important differential diagnosis in those with non-specific GI symptoms and suspected eating disorder—and highlight baseline investigations which should be performed to ensure a diagnosis of IBD is not missed in these patients.

scholarly journals Prevalence and Duration of Gastrointestinal Symptoms Before Diagnosis of Inflammatory Bowel Disease and Predictors of Timely Specialist Review: A Population-Based Study

2020 ◽  
Author(s):  
J Blackwell ◽  
S Saxena ◽  
N Jayasooriya ◽  
A Bottle ◽  
I Petersen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Delayed Diagnosis ◽  
Gastrointestinal Symptoms ◽  
Care Physician ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Background Population ◽  
Gi Symptoms ◽  
Inflammatory Bowel

Abstract Background and Aims Lack of timely referral and significant waits for specialist review amongst individuals with unresolved gastrointestinal [GI] symptoms can result in delayed diagnosis of inflammatory bowel disease [IBD]. Aims To determine the frequency and duration of GI symptoms and predictors of timely specialist review before the diagnosis of both Crohn’s disease [CD] and ulcerative colitis [UC]. Methods This is a case control study of IBD matched 1:4 for age and sex to controls without IBD using the Clinical Practice Research Datalink from 1998 to 2016. Results We identified 19 555 cases of IBD and 78 114 controls. One in four cases of IBD reported GI symptoms to their primary care physician more than 6 months before receiving a diagnosis. There was a significant excess prevalence of GI symptoms in each of the 10 years before IBD diagnosis. GI symptoms were reported by 9.6% and 10.4% at 5 years before CD and UC diagnosis respectively compared to 5.8% of controls. Amongst patients later diagnosed with IBD, <50% received specialist review within 18 months from presenting with chronic GI symptoms. Patients with a previous diagnosis of irritable bowel syndrome [IBS] or depression were less likely to receive timely specialist review (IBS: hazard ratio [HR] = 0.77, 95% confidence interval [CI] 0.60–0.99, depression: HR = 0.77, 95% CI 0.60–0.98). Conclusions There is an excess of GI symptoms 5 years before diagnosis of IBD compared to the background population, probably attributable to undiagnosed disease. Previous diagnoses of IBS and depression are associated with delays in specialist review. Enhanced pathways are needed to accelerate specialist referral and timely IBD diagnosis.

scholarly journals Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice

2020 ◽  
Vol 4 (1) ◽  
pp. e000786
Author(s):  
Abbie Maclean ◽  
James J Ashton ◽  
Vikki Garrick ◽  
R Mark Beattie ◽  
Richard Hansen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Delayed Diagnosis ◽  
High Standard ◽  
Current Evidence ◽  
Faecal Calprotectin ◽  
Paediatric Patients ◽  
Inflammatory Bowel ◽  
Working Practices ◽  
The Impact

The assessment and management of patients with known, or suspected, paediatric inflammatory bowel disease (PIBD) has been hugely impacted by the COVID-19 pandemic. Although current evidence of the impact of COVID-19 infection in children with PIBD has provided a degree of reassurance, there continues to be the potential for significant secondary harm caused by the changes to normal working practices and reorganisation of services.Disruption to the normal running of diagnostic and assessment procedures, such as endoscopy, has resulted in the potential for secondary harm to patients including delayed diagnosis and delay in treatment. Difficult management decisions have been made in order to minimise COVID-19 risk for this patient group while avoiding harm. Initiating and continuing immunosuppressive and biological therapies in the absence of normal surveillance and diagnostic procedures have posed many challenges.Despite this, changes to working practices, including virtual clinic appointments, home faecal calprotectin testing kits and continued intensive support from clinical nurse specialists and other members of the multidisciplinary team, have resulted in patients still receiving a high standard of care, with those who require face-to-face intervention being highlighted.These changes have the potential to revolutionise the way in which patients receive routine care in the future, with the inclusion of telemedicine increasingly attractive for stable patients. There is also the need to use lessons learnt from this pandemic to plan for a possible second wave, or future pandemics as well as implementing some permanent changes to normal working practices.In this review, we describe the diagnosis, management and direct impact of COVID-19 in paediatric patients with IBD. We summarise the guidance and describe the implemented changes, evolving evidence and the implications of this virus on paediatric patients with IBD and working practices.

scholarly journals IMAGINE Network’s Mind And Gut Interactions Cohort (MAGIC) Study: a protocol for a prospective observational multicentre cohort study in inflammatory bowel disease and irritable bowel syndrome

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e041733
Author(s):  
Paul Moayyedi ◽  
Glenda MacQueen ◽  
Charles N Bernstein ◽  
Stephen Vanner ◽  
Premysl Bercik ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Cohort Study ◽  
Bowel Disease ◽  
Gut Microbiome ◽  
Psychological Status ◽  
Healthy Controls ◽  
Gi Symptoms ◽  
Inflammatory Bowel ◽  
Irritable Bowel

IntroductionGut microbiome and diet may be important in irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and comorbid psychiatric conditions, but the mechanisms are unclear. We will create a large cohort of patients with IBS, IBD and healthy controls, and follow them over time, collecting dietary and mental health information and biological samples, to assess their gastrointestinal (GI) and psychological symptoms in association with their diet, gut microbiome and metabolome.Methods and analysisThis 5-year observational prospective cohort study is recruiting 8000 participants from 15 Canadian centres. Persons with IBS who are 13 years of age and older or IBD ≥5 years will be recruited. Healthy controls will be recruited from the general public and from friends or relatives of those with IBD or IBS who do not have GI symptoms. Participants answer surveys and provide blood, urine and stool samples annually. Surveys assess disease activity, quality of life, physical pain, lifestyle factors, psychological status and diet. The main outcomes evaluated will be the association between the diet, inflammatory, genetic, microbiome and metabolomic profiles in those with IBD and IBS compared with healthy controls using multivariate logistic regression. We will also compare these profiles in those with active versus quiescent disease and those with and without psychological comorbidity.Ethics and disseminationApproval has been obtained from the institutional review boards of all centres taking part in the study. We will develop evidence-based knowledge translation initiatives for patients, clinicians and policymakers to disseminate results to relevant stakeholders.Trial registration number:NCT03131414

Faecal markers of gastrointestinal inflammation

2012 ◽  
Vol 65 (11) ◽  
pp. 981-985 ◽  
Author(s):  
Roy A Sherwood
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Waiting Times ◽  
Indeterminate Colitis ◽  
Faecal Calprotectin ◽  
Infectious Colitis ◽  
Inflammatory Conditions ◽  
Gi Symptoms ◽  
Rome Iii ◽  
Inflammatory Bowel

Gastrointestinal (GI) symptoms including abdominal pain, bloating and diarrhoea are a relatively common reason for consulting a physician. They may be due to inflammatory bowel disease (inflammatory bowel disease; Crohn's disease, ulcerative colitis and indeterminate colitis), malignancy (colorectal cancer), infectious colitis or irritable bowel syndrome (IBS). Differentiation between these involves the use of clinical, radiological, endoscopic and serological techniques, which are invasive or involve exposure to radiation. Serological markers include C-reactive protein, erythrocyte sedimentation rate and antibodies (perinuclear antineutrophil cytoplasm antibody and anti-Saccharomyces cerevisiae antibody). Faecal markers that can aid in distinguishing inflammatory disorders from non-inflammatory conditions are non-invasive and generally acceptable to the patient. As IBS accounts for up to 50% of cases presenting to the GI clinic and is a diagnosis of exclusion (Rome III criteria), any test that can reliably distinguish IBS from organic disease could speed diagnosis and reduce endoscopy waiting times. Faecal calprotectin, lactoferrin, M2-PK and S100A12 will be reviewed.

scholarly journals P157 Reasons for a delayed diagnosis in inflammatory bowel disease

2013 ◽  
Vol 7 ◽  
pp. S72
Author(s):  
A. Degen ◽  
C. Büning ◽  
B. Siegmund ◽  
M. Prager ◽  
J. Maul ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Delayed Diagnosis ◽  
Inflammatory Bowel

scholarly journals Eating habits in patients with inflammatory bowel disease

2021 ◽  
Vol 11 (8) ◽  
pp. 255-260
Author(s):  
Aleksandra Iwona Zimna ◽  
Hubert Wróblewski
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Eating Habits ◽  
Meat Products ◽  
White Bread ◽  
Blue Cheese ◽  
Inflammatory Bowel

Wstęp : Wrzodziejące zapalenie jelita grubego i choroba Leśniowskiego-Crohna są najczęstszymi chorobami zapalnymi jelit. Farmakoterapia odgrywa dużą rolę w leczeniu zarówno zaostrzeń, jak i remisji, jednak ważna jest również dieta, którą należy dobierać indywidualnie do potrzeb pacjenta, zwłaszcza biorąc pod uwagę potrzeby pacjenta. reakcja na pokarm i objawy, których obecnie doświadczasz. Celem wprowadzenia diety jest m.in. ułatwienie regeneracji jelit, przyspieszenie i wydłużenie okresu remisji choroby oraz zapobieganie niedożywieniu u pacjentów.Cel: Celem pracy jest analiza nawyków żywieniowych i diety pacjentów z IBD w okresie remisji.Materials and methods: The results were obtained on the basis of a questionnaire survey.Results: 95 people took part in the survey, 56.4% of them suffer from UC and 43.6% from CDI, 48.5% of respondents admit that they smoke more than 10 cigarettes a day. As many as 43.6% do not do any sports More than half of respondents eat white bread and exclude blue cheese from the diet. 24.5% of respondents are mostly meat products and 13.8% - vegetables. Only 27% of respondents use probiotics, only 40% consume pickled products regularly. Almost 6% do not eat fish and 35 people do it sporadically, unlike poultry, which is eaten several times a week by less than half of the respondents, 27 of the respondents excluded smoked meats from their diets. Only 25% of the respondents do not consume NSAIDs, while for 6% their consumption is everyday life.Wnioski: Z przeprowadzonych badań wynika, że istnieje ciągła potrzeba edukowania pacjentów w zakresie zdrowego stylu życia, w tym promowania aktywności fizycznej oraz przestrzegania szkodliwego wpływu palenia na ich zdrowie, życie i przebieg chorób poprzez podkreślanie CDD, ponieważ palenie tytoniu pogłębia tę chorobę , podobnie jak zażywanie NLPZ. Analizując uzyskane wyniki należy zwrócić uwagę na małe zainteresowanie spożywaniem probiotyków, które mają pozytywny wpływ na mikroflorę jelitową oraz podkreślić korzyści płynące ze spożywania produktów marynowanych. Wydaje się, że dobór produktów spożywczych i stosowanej przez respondentów diety jest wyrazem indywidualnych potrzeb, subiektywnych przekonań i preferencji

scholarly journals Extra Intestinal Manifestations in Children with Inflammatory Bowel Disease, A Single Center Report from Iran

2021 ◽  
Vol 9 (2) ◽  
pp. 5
Author(s):  
Seyed Mohsen Dehghani ◽  
Iraj Shahramian ◽  
Ali Bazi ◽  
Seyedeh Zeinab Fereidouni ◽  
Asma Erjaee ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Unknown Etiology ◽  
Single Center ◽  
Medical Sciences ◽  
Center Report ◽  
Gi Symptoms ◽  
Inflammatory Bowel ◽  
The Mean

Introduction: Inflammatory bowel disease (IBD) is a disorder of unknown etiology categorized into three groups including Crohn disease (CD), ulcerative colitis [UC], and intermediate colitis (IC). In addition to gastrointestinal (GI) symptoms, childhood IBD frequently present with extra GI manifestations. In present study, we aimed to determine extra GI symptoms in children with IBD in Iran. Methods: Children <18 years old with established IBD diagnosis referred to the Gastroenterology Clinic affiliated with Shiraz University of Medical Sciences during 2007-2017 were included. Results: Eighty-five children were assessed. CD and UC comprised 26 (30.6%) and 47 (55.3%) of the patients. The mean age was 14.09±2.5 years old with 50% of them were boys. The most frequent presenting complaint was rectal bleeding (37.2%). In patients with CD and UC, 30% and 29% of the patients represented at least one extra GI symptom. The most common extra GI manifestations were growth retardation (11.5%) and arthralgia (7.8%) in children with CD and UC respectively. Conclusions: Extra GI symptoms are relatively common in children with IBD. Caution should be taken to avoid confusion with other disorders and to timely manage these manifestations.

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