Intestinal Absorption and Pancreatic Function are Preserved in Anorexia Nervosa Patients in Both a Severely Malnourished State and After Recovery

Introduction Anorexia nervosa (AN) is characterised by a refusal to normal body weight accompanied by a marked restriction of food intake, frequently leading to severe malnutrition. In severe malnutrition and wasting syndromes, mucosal atrophy, altered gastrointestinal motility and pancreatic atrophy, which alter digestive function and can exacerbate malnutrition, have been described. The objective of this work was to determine intestinal absorption and pancreatic function in severely malnourished AN patients before and after recovery. Methods Ten severely malnourished AN women were studied at hospital admittance (body mass index=11.4416.16kg/m2) and after weight recovery with artificial nutrition (body mass index20kg/m2). A 13C-labelled triglycerides digestion test, faecal elastase test and d-xylose absorption test were performed. Results In nine patients, 13C-labelled triglycerides digestion tests and the faecal elastase and d-xylose tests were normal both before and after weight recovery. In one patient, the results were abnormal, and they led to the detection of a previously undiagnosed celiac disease in addition to her AN. Conclusion In this series, there was neither intestinal absorption nor pancreatic function disturbances in severely malnourished AN patients either before or after weight recovery. The usefulness of these tests in the differentiation of functional versus structural changes needs further studies. Copyright (c) 2013 John Wiley & Sons, Ltd and Eating Disorders Association.