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Anorexia nervosa complicating inflammatory bowel disease.
Archives of Disease in Childhood
|March 1, 1990
Summary
Inflammatory bowel disease (IBD) and anorexia nervosa in adolescents present complex management challenges. Corticosteroid treatment for IBD may trigger anorexia nervosa, while abrupt withdrawal risks severe IBD complications.
Area of Science:
- Gastroenterology
- Psychiatry
- Adolescent Medicine
Background:
- Inflammatory bowel disease (IBD) and anorexia nervosa (AN) are serious conditions requiring specialized care.
- Co-occurrence of IBD and AN in adolescents poses significant therapeutic dilemmas.
Observation:
- Two adolescent cases illustrate the intricate interplay between IBD management and AN.
- Corticosteroid therapy for IBD was implicated in precipitating AN in one patient.
- Steroid withdrawal in another patient led to life-threatening IBD exacerbation.
Findings:
- Managing comorbid IBD and AN in adolescents is exceptionally challenging.
- Corticosteroids may act as a trigger for AN development in susceptible individuals.
- Abrupt cessation of steroids can result in severe, potentially fatal, IBD complications.
Implications:
- Highlights the need for multidisciplinary specialist care for adolescents with comorbid IBD and AN.
- Warns against the use of "shape modifying drugs" in this vulnerable population.
- Emphasizes careful consideration of psychotropic medication and steroid management in dual-diagnosis patients.