Inflammatory Bowel Disease and Eating Disorders: A systematized review of comorbidity

- Symptomatology overlaps between Inflammatory Bowel Disease and Eating Disorders.
- Comorbidity should be considered in the differential diagnosis.
- Crohn's Disease and Anorexia Nervosa is the most frequent reported comorbidity.
- A delayed diagnosis of this comorbidity may lead to poorer prognosis.
- A multidisciplinary approach would be necessary to manage these cases.

ObjectiveResearch has shown that there is an association between Inflammatory Bowel Disease, anxiety and mood disorders, however little is known about their association with Eating Disorders. In this paper we will present a case of a young female with a comorbid diagnosis of Inflammatory Bowel Disease and Eating Disorder, and then discuss the results from a systematic review of the literature, describing published cases of patients with the same condition.MethodsA systematized review of the literature was conducted according to MOOSE guidelines. A computerized literature search of MEDLINE, PsycINFO and EMBASE, and a manual search through reference lists of selected original articles were performed to identify all published case-reports, case series and studies of Inflammatory Bowel Disease and Eating Disorders.ResultsFourteen articles were included, encompassing 219 cases, including ours. The vast majority were females ranging from 10 to 44 years old. Anorexia Nervosa (n = 156) and Crohn's Disease (n = 129) was the most frequent combination (n = 90) reported in the literature. These cases present a poor prognosis because of corticoid refusal, medication abandon and/or deliberate exacerbation of IBD symptoms, in the context of trying to lose weight.ConclusionRecent evidence suggests there is a possible association between Inflammatory Bowel Disease and Eating Disorders, although the mechanisms involved in its ethiopathogenesis are still unknown. To be aware of this association is important because a delayed diagnosis of this comorbidity may lead to worse prognosis. Further research and a multidisciplinary approach could facilitate earlier diagnosis and provide therapeutic interventions.