Singapore Med J. 1997 Aug;38(8):332-5.
Anorexia nervosa and bulimia--a Singapore perspective.
Ung EK, Lee S, Kua EH.
Department of Psychological Medicine, National University Hospital, Singapore.
OBJECTIVE: To study the clinical characteristics of patients with anorexia nervosa and bulimia. METHOD: Fifty patients presenting to our department from 1991-1996 were identified and studied retrospectively. RESULTS: There was an increase in presentations for anorexia and bulimia over the period studied. The majority exhibited body image disturbance, morbid fear of fatness and compulsive efforts to lose weight, not dissimilar to that described in the Western literature. Significant transcultural differences were not found. Those with significant binge eating were more likely to present at a later age, have a higher BMI, menorrhoea, associated vomiting and/or laxative use, have prominent depressive symptoms and a history of self-harm. Compared to anorexics, bulimics were more likely to have relationship stresses and a history of self-harm. CONCLUSION: The clinical characteristics of anorexics and bulimics are more striking for their similarities rather than differences to that described in the West.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9364886&dopt=Abstract constipation laxative
Pharmacology. 1988;36 Suppl 1:66-72.
Combined manometric and radiological study of the changes in colonic motility induced by sennosides in rats.
Spiessens C, Ceuterick L, Ponette E, Janssens J, Lemli J.
Department of Pharmaceutical Biology and Phytopharmacology, K.U. Leuven, Belgium.
Colonic motility changes induced by sennosides in rats were studied by an original method, which permits the simultaneous projection of manometric and fluoroscopic registrations on a single monitor. The results of this study allowed us to confirm the laxative effect of sennosides by inducing mass movements within 60-80 min after intracecal administration leading to a complete emptying of the whole colon. These mass movements were preceded by hypotonia of cecum and colon and impeded pellet formation.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3368527&dopt=Abstract constipation laxative
Dis Colon Rectum. 1997 Nov;40(11):1382-5.
Rectal prolapse associated with bulimia nervosa: report of seven cases.
Malik M, Stratton J, Sweeney WB.
Department of Surgery, University of Massachusetts Medical Center, Worcester 01655, USA.
PURPOSE: Rectal prolapse is a condition in which, when complete, the full thickness of the rectal wall protrudes through the anus. Bulimia nervosa is an eating disorder characterized by periodic food binges, which are followed by purging. Purging usually takes the form of self-induced vomiting, laxative abuse, and/or diuretic abuse. We report seven cases of rectal prolapse associated with bulimia nervosa. METHODS: The case histories of seven women with rectal prolapse and bulimia nervosa, average age 29 (range 21-42) years, seen over a period of 11 years (1987-1997) were reviewed. An analysis of the clinical data, including history, presenting physical examination, surgical treatment, and outcome was performed. RESULTS: All seven patients had a diagnosis of bulimia nervosa, made either before or with a diagnosis of rectal prolapse. Rectal prolapse was confirmed in each patient at anorectal examination. Five patients underwent sigmoid resection with proctopexy, one died before operative therapy, and one awaits further treatment. One of the five surgical patients had a recurrence that was managed by a perineal rectosigmoidectomy. CONCLUSION: To our knowledge, despite extensive review of both bulimia nervosa and rectal prolapse as seen in the medical literature, an association between the two has not been described previously. Several aspects of bulimia nervosa, including constipation, laxative use, overzealous exercise, and increased intra-abdominal pressure from forced vomiting are likely causes for the probable relationship with rectal prolapse. The possibility that an atypically young female presenting with rectal prolapse may also have bulimia nervosa should be taken into account by clinicians. This may assist the diagnosis of bulimia nervosa, a disease with
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