Presumption, nausea, bowel distension, abdominal pain and early satiety are very common in patients with Anorexia nervosa (AN). These problems may give rise to significant medical complications and may contribute to increased difficulties with refeeding and weight restoration. The aim of our study was to evaluate the influence of gatrointestinal treatment on weight gain in AN patients. Esophagogastroduodenoscopy with gastric mucose biopsy were performed in 19 AN patients (DSM-IV criteria) with digestive problems (mean age 22.4±0.7 years, BMI 15.9±2.3 kg/m2) Patohistological finding confirmed chronic gastritis in all AN patients and in ten patients Helicobacter pylori (HP) infection was found. The same examination was pereformed in 19 aged matched controls (25.2±0.7 years, BMI 19.8±0.4 kg/m2). No significant difference was found between HP positive and negative AN patients at the beginning of gastrointestinal treatment in BMI (15.86±1.4 vs 16.1±1.17 kg/m2, P>0.05), as well as in serum leptin levels (1.69±0.56 vs 2.38±2.1 ng/ml, P>0.05). However, significant differences in BMI and serum leptin levels in AN vs controls(BMI 15.98±1.3 vs 19.8±0.4 kg/m2, P<0.01; leptin 2.48±0.5 vs 9.1±1.6 ng/ml, P< 0.01) were found. All AN patients were on hypernutrition and gastrointestinal therapy. After 6 months, in AN patients, significant difference in BMI and serum leptin concentrations (BMI 15.98±1.3 vs 18.0±1.3 kg/m2, P<0.001, leptin 2.48±0.5 vs 4.9±0.7 ng/ml, P<0.001) were found.
Conclusion: Knowledge and treatment of gastrointestinal complications may be of critical importance in successful nutritive recovery in AN patients.