“Waste” of a CT Scan

M Alsayid, V Kotwal. Clin Gastroenterol Hepatol 2022; DOI:https://doi.org/10.1016/j.cgh.2021.06.030. Open Access: Chronic Constipation With Fecal Stasis

A 50 year old with a history of abdominal distention for a week and chronic constipation had a CT with intravenous contrast. Ultimately he had a disimpaction under general anesthesia and a flexible sigmoidoscopy.

My view: A complete examination with digital rectal exam (if feasible) or an AXR would have been sufficient for diagnosis.

Blog note: Link for We Can’t Wait App updated in yesterday’s post.

Should We Be Screening for Eating Disorders in Teenagers with Constipation?

HB Murray et al. Clin Gastroenterol Hepatol 2020; 18: 2471-2478. Frequency of Eating Disorder Pathology Among Patients With Chronic Constipation and Contribution of Gastrointestinal-Specific Anxiety

Key findings:

  • In an analysis (n= 279 adults, 70% female, average age 47 years) of patients with chronic constipation at a tertiary center who were referred for anorectal manometry, 19% had symptoms consistent with an eating disorder; this assessment was based on the Eating Attitudes Test (EAT-26).
  • “Gastrointestinal-specific anxiety fully mediated the relationship between the severity of ED pathology and constipation (standardized β, 0.11–0.16; P = .026–.024).”

The authors note that screening for eating disorders “is of particular importance before prescribing dietary interventions.”

My take: While this was a study with adults, it is likely that chronic constipation may be a presenting feature of an eating disorder in teenagers as well.