Case Study: Exploring Gastrin Dysregulation in Anorexia Nervosa
Patient Background: Sarah, a 19-year-old college student, was admitted to the psychiatric unit with a diagnosis of anorexia nervosa. She presented with a history of severe food restriction, excessive exercise, and a distorted body image. Sarah’s symptoms had progressively worsened over the past year, leading to significant weight loss, amenorrhea, and social withdrawal. Upon admission, Sarah’s BMI was 16.5, indicative of severe underweight.
Clinical Presentation: During the initial assessment, Sarah reported experiencing gastrointestinal symptoms, including bloating, abdominal discomfort, and constipation. Laboratory tests revealed electrolyte imbalances, indicating malnutrition, and hormonal disturbances consistent with anorexia nervosa. Of particular interest was the observation of low serum gastrin levels, raising concerns about gastric function and potential dysregulation of gastrin in Sarah’s condition.
Diagnostic Evaluation: Further investigations, including upper gastrointestinal endoscopy and gastric motility studies, were conducted to assess Sarah’s gastric function comprehensively. The endoscopy revealed mild gastritis and decreased gastric mucosal integrity, suggestive of chronic gastrin suppression and reduced acid secretion. Gastric motility studies demonstrated delayed gastric emptying, consistent with dysregulated gastrointestinal motility patterns commonly observed in individuals with eating disorders.
Treatment Approach: Sarah’s treatment plan encompassed a multidisciplinary approach involving psychiatric, medical, and nutritional interventions. Psychiatric therapy focused on addressing Sarah’s distorted body image, fear of weight gain, and underlying psychological stressors contributing to her disordered eating behaviors. Medical management aimed to restore Sarah’s nutritional status and correct electrolyte imbalances through gradual refeeding and electrolyte supplementation. Additionally, Sarah received nutritional counseling to promote balanced eating habits and normalize her relationship with food.
Therapeutic Response: Over the course of her hospitalization, Sarah demonstrated gradual improvement in her psychiatric symptoms and nutritional status. With ongoing psychiatric support and nutritional rehabilitation, Sarah’s weight stabilized, and her gastrointestinal symptoms ameliorated. Serial laboratory monitoring revealed normalization of electrolyte levels and a modest increase in serum gastrin concentrations, suggesting partial restoration of gastric function.
Follow-up and Long-Term Outlook: Upon discharge, Sarah transitioned to outpatient care, where she continued to receive ongoing psychiatric treatment, nutritional counseling, and medical monitoring. Long-term follow-up appointments were scheduled to assess Sarah’s progress and address any potential relapse of her eating disorder symptoms. With continued support and adherence to her treatment plan, Sarah remained committed to her recovery journey, emphasizing the importance of holistic care in the management of anorexia nervosa and its associated gastrointestinal complications.
Conclusion: Sarah’s case highlights the intricate relationship between gastrin dysregulation and anorexia nervosa, underscoring the importance of comprehensive assessment and multidisciplinary management in treating individuals with eating disorders. By addressing both the psychological and physiological aspects of anorexia nervosa, healthcare providers can optimize outcomes and promote sustained recovery in affected individuals. Sarah’s journey serves as a testament to the resilience and perseverance of individuals battling eating disorders, offering hope for recovery and restoration of health and well-being.