Gastrointestinal symptoms following treatment for anorexia nervosa: A systematic literature review

Objective Gastrointestinal (GI) disturbances are a frequent and burdensome experience for patients with anorexia nervosa (AN). How GI symptoms respond to current interventions is not well characterized, yet is critical to facilitate treatment success, and to inform the development of new treatments for AN. Therefore, the aim of this systematic review was to identify which treatments are effective in improving GI symptoms in patients with AN. Method A systematic search for studies of AN treatments measuring GI symptoms pre‐ and post‐treatment was conducted in May 2020 (PROSPERO ID: CRD42020181328). After removal of duplicates, title and s of 3,370 studies were screened. Methodological quality was assessed using National Institute of Health Quality Assessment Tool. Results Following full‐text screening, 13 studies (12 observational studies and 1 randomized double‐blind placebo‐controlled trial) with 401 participants met eligibility criteria and were included. All observational studies included a component of nutritional rehabilitation, with half (n = 6) involving concurrent psychological treatment. The randomized controlled trial reported a drug therapy. Eleven studies reported an improvement in all (n = 6) or at least one (n = 5) patient‐reported GI symptom following treatment. Two studies reported no change. Methodological quality was fair or poor across all studies. Discussion This is the first systematic review to synthesize available evidence on the trajectory of patient‐reported GI symptoms from commencement to end of treatment for AN. The results suggest that most studies showed improvement in one or more GI symptom in response to current treatments. Future therapeutic approaches should consider GI symptoms within their design for optimal treatment adherence and outcomes. Resumen Objetivo Las alteraciones gastrointestinales (GI) son una experiencia frecuente y gravosa para los pacientes que padecen anorexia nerviosa (AN). La forma en que los síntomas gastrointestinales responden a las intervenciones actuales no está bien caracterizada, sin embargo es fundamental para facilitar el éxito del tratamiento, e informar el desarrollo de nuevos tratamientos para la AN. Por lo tanto, el objetivo de esta revisión sistemática fue identificar qué tratamientos son eficaces para mejorar los síntomas gastrointestinales en pacientes que padecen AN. Método En mayo de 2020 se llevó a cabo una búsqueda sistemática de estudios de tratamientos para AN que midieron los sín