Essstörungen für den/die Gastroenterologen:in – was sich zu wissen lohnt

Zusammenfassung

Essstörungen sind potenziell lebensbedrohliche Erkrankungen, die mit schweren psychischen und somatischen Komorbiditäten einhergehen. Man geht davon aus, dass die Anzahl an Patienten im Nachgang der Covid-Pandemie stark ansteigen wird.

Hauptsächlich 4 Essstörungen werden im Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) und der International Classification of Diseases 11 (ICD-11) erwähnt: Anorexia nervosa (AN), Bulimia nervosa (BN), Binge eating disorder (BED) und Avoidant restrictive food intake disorder (ARFID). Viele traditionelle Annahmen bei Essstörungen sind aufgrund neuer Forschungsresultate im Wandel begriffen. Der/die Gastroenterologe/in ist normalerweise nicht die erste Anlaufstelle für Patienten/-innen mit Essstörungen. Er spielt jedoch eine zentrale Rolle, insbesondere wenn es um das Management von gastroenterologischen Komplikationen geht.

In dieser Übersicht soll der Fokus vor allem auf relevante gastroenterologische Aspekte und weniger auf die psychiatrische/psychosomatische Behandlung gelegt werden. Die Grundlagen der wichtigsten Essstörungen werden wiederholt, Möglichkeiten der Erkennung und wichtige gastroenterologische Komplikationen genannt. Die Adipositas, die oft mit Essstörungen einhergeht, ist nicht Gegenstand dieser Übersicht.

Abstract

Eating disorders are potentially life-threatening disorders that go along with severe psychiatric and somatic comorbidities. It is expected that the number of patients will dramatically increase in the post COVID-19 pandemic era.

Four main eating disorders are mentioned in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) and the International Classification of Diseases 11 (ICD-11): anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) und avoidant restrictive food intake disorder (ARFID). Many traditional assumptions in eating disorders are currently challenged due to recent research results. The gastroenterologist is usually not the first point of contact for patients with eating disorders. However, he is crucial, especially in the management of gastroenterologic complications of eating disorders.

Focus of the overview will be on relevant gastroenterologic aspects and less on the psychiatric treatment. Basics of the most common eating disorders will be repeated, opportunities in diagnosing an eating disorder and the most relevant gastroenterologic complications will be described. Obesity and its management, an entity that often goes along with an eating disorder, is not in the spotlight of the review.

Schlüsselwörter

Essstörung - Anorexie - Bulimie - Mikrobiom - Gut-Brain-Achse - Gastroparese - Diät

Keywords

eating disorder - anorexia - bulimia - microbiom - gut-brain-axis - gastroparesis - diet

Publication History

Received: 02 August 2022

Accepted after revision: 05 January 2023

Article published online:
08 May 2023

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