Eating Disorders Overview and Anorexia Nervosa
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Questions and Answers

Which symptom is NOT typically associated with anorexia nervosa in adolescent females?

  • Excessive weight gain (correct)
  • Hypotension
  • Brittle hair and nails
  • Amenorrhea

    • What is a key component of the DSM-5 diagnostic criteria for anorexia nervosa?

  • Intense fear of gaining weight despite being underweight (correct)
  • Binge eating followed by compensatory behaviors
  • Excessive eating episodes followed by purging
  • A body mass index above 25

    • Which of the following is a common comorbid psychiatric disorder associated with anorexia nervosa?

  • Depression (correct)
  • Schizophrenia
  • Bipolar disorder
  • Obsessive-compulsive disorder

    • What treatment approach is emphasized for managing anorexia nervosa?

    <p>Collaborative care involving a team approach</p> Signup and view all the answers

    What percentage of individuals with anorexia nervosa is expected to achieve full remission?

    <p>50%</p> Signup and view all the answers

    Which of the following statements correctly describes the diagnostic criteria for bulimia nervosa regarding binge eating episodes?

    <p>A sense of lack of control during binge eating is a characteristic feature.</p> Signup and view all the answers

    What is indicated by 'in partial remission' in the context of bulimia nervosa?

    <p>Some, but not all, criteria have been met for a sustained period of time.</p> Signup and view all the answers

    Which of the following is a common comorbid psychiatric disorder associated with bulimia nervosa?

    <p>Obsessive-Compulsive Disorder</p> Signup and view all the answers

    What is a primary focus of the collaborative care team management approach for bulimia nervosa?

    <p>Integration of family, psychotherapy, and medical professionals.</p> Signup and view all the answers

    Which of the following is a characteristic feature of anorexia nervosa?

    <p>An intense fear of gaining weight despite being underweight.</p> Signup and view all the answers

    Which electrolyte imbalances might be evaluated in the context of anorexia nervosa?

    <p>Sodium, potassium, and chloride levels.</p> Signup and view all the answers

    What is the prognosis for individuals with bulimia nervosa?

    <p>50-70% of individuals show improvement or recovery.</p> Signup and view all the answers

    Which of the following aspects is emphasized in the diagnostic criteria for bulimia nervosa?

    <p>Self-evaluation heavily influenced by body shape and weight.</p> Signup and view all the answers

    What is considered a requirement for diagnosing binge-eating disorder according to the DSM-5 criteria?

    <p>Experiencing a sense of lack of control over eating during episodes.</p> Signup and view all the answers

    Which symptom is NOT typically associated with binge-eating episodes?

    <p>Eating while engaging in social interactions.</p> Signup and view all the answers

    In binge-eating disorder, how is the severity determined?

    <p>By the number of binge-eating episodes per week.</p> Signup and view all the answers

    What is the prognosis for individuals with binge-eating disorder without treatment?

    <p>Approximately 90% will have resolution within five years.</p> Signup and view all the answers

    Which of the following is NOT a common characteristic of binge-eating disorder?

    <p>Strictly following a diet plan prior to binge episodes.</p> Signup and view all the answers

    Which type of care team is recommended for managing binge-eating disorder?

    <p>A collaborative care team involving multiple specialties.</p> Signup and view all the answers

    Which of the following is a common demographic profile for individuals with binge-eating disorder?

    <p>Young females, especially adolescents, often classified as obese.</p> Signup and view all the answers

    What percentage of individuals with binge-eating disorder may continue to experience clinical symptoms after five years?

    <p>18%</p> Signup and view all the answers

    Which condition is characterized by diarrhea caused by hepatic overproduction of bile acids or their malabsorption?

    <p>Bile acid diarrhea</p> Signup and view all the answers

    What diagnostic test is most sensitive for evaluating bile acid malabsorption?

    <p>SeHCAT (48.4 ng/mL)</p> Signup and view all the answers

    What is a common precipitating factor for Clostridioides difficile-associated diarrhea?

    <p>Recent antibiotic therapy</p> Signup and view all the answers

    Which symptom is associated with bile acid diarrhea?

    <p>Fecal incontinence</p> Signup and view all the answers

    How is the prognosis for bile acid diarrhea determined?

    <p>Based on the underlying cause and tolerance to treatment</p> Signup and view all the answers

    What is a significant complication of untreated Clostridioides difficile infection?

    <p>Dehydration</p> Signup and view all the answers

    What management approach is recommended for bile acid diarrhea?

    <p>Bile acid sequestrants</p> Signup and view all the answers

    Which factor is NOT typically associated with increased risk for Clostridioides difficile infection?

    <p>Frequent handwashing</p> Signup and view all the answers

    Which of the following conditions is most likely associated with the presence of excessive bacteria in the small intestine?

    <p>Small intestine bacterial overgrowth (SIBO)</p> Signup and view all the answers

    What is a common diagnostic method for confirming carbohydrate malabsorption?

    <p>Hydrogen breath test</p> Signup and view all the answers

    Which of the following conditions is most commonly associated with an elevated risk of lymphoma when untreated?

    <p>Celiac disease</p> Signup and view all the answers

    Which finding is indicative of Crohn's disease according to laboratory testing?

    <p>Elevated fecal calprotectin levels</p> Signup and view all the answers

    What is a primary symptom of non-celiac gluten sensitivity?

    <p>Absence of autoimmune markers</p> Signup and view all the answers

    What is a potential complication of untreated small intestine bacterial overgrowth (SIBO)?

    <p>Intestinal failure</p> Signup and view all the answers

    In diagnosing celiac disease, which of the following serologic tests has the highest sensitivity?

    <p>IgA tissue transglutaminase</p> Signup and view all the answers

    Which factor is least likely to be a symptom of celiac disease?

    <p>Dizziness</p> Signup and view all the answers

    In patients with carbohydrate malabsorption, which carbohydrate is most associated with malabsorption leading to abdominal symptoms?

    <p>Lactose</p> Signup and view all the answers

    What lifestyle factor has been shown to significantly increase the risk of developing Crohn's disease?

    <p>Smoking</p> Signup and view all the answers

    What is a common feature of small intestine bacterial overgrowth?

    <p>Increased intestinal gas formation</p> Signup and view all the answers

    Which symptom is least likely to be associated with small intestine bacterial overgrowth (SIBO)?

    <p>Severe fatigue</p> Signup and view all the answers

    Which dietary modification is crucial in the management of celiac disease?

    <p>Gluten-free diet</p> Signup and view all the answers

    Which serologic test is least sensitive for diagnosing celiac disease?

    <p>IgG tissue transglutaminase</p> Signup and view all the answers

    What would be the primary management approach for carbohydrate malabsorption due to enzyme deficiencies?

    <p>Diet modification</p> Signup and view all the answers

    What is a common consequence of disordered eating patterns in individuals affected by anorexia nervosa?

    <p>Electrolyte imbalances</p> Signup and view all the answers

    Which of the following is NOT a common symptom of Crohn's disease?

    <p>Hyperglycemia</p> Signup and view all the answers

    What is a possible symptom of carbohydrate malabsorption?

    <p>Abdominal bloating</p> Signup and view all the answers

    What is the prevalence of SIBO in the general public?

    <p>15%</p> Signup and view all the answers

    Which type of testing is critical for confirming a diagnosis of non-celiac gluten sensitivity?

    <p>Gluten challenge</p> Signup and view all the answers

    Which of the following factors is commonly associated with the development of Barrett's Esophagus?

    <p>Long-standing GERD</p> Signup and view all the answers

    In the context of gastritis, which of the following describes erosive gastritis?

    <p>Severe damage leading to bleeding</p> Signup and view all the answers

    What percentage of individuals with Barrett's Esophagus is at risk of developing esophageal adenocarcinoma?

    <p>&lt; 1%</p> Signup and view all the answers

    Which management strategy is typically recommended for individuals diagnosed with chronic gastritis?

    <p>Dietary and lifestyle changes</p> Signup and view all the answers

    What is the primary diagnostic method used for identifying Barrett's Esophagus?

    <p>Endoscopy and biopsy</p> Signup and view all the answers

    Which of the following is a common characteristic symptom of functional dyspepsia according to the ROME IV criteria?

    <p>Early satiety experienced at least 3 days a week</p> Signup and view all the answers

    Which factor is most likely to aggravate gastroesophageal reflux disease (GERD) symptoms?

    <p>Intake of citrus foods</p> Signup and view all the answers

    What percentage of the general population is estimated to be affected by gastroesophageal reflux disease (GERD)?

    <p>Up to 35%</p> Signup and view all the answers

    Which type of pain is commonly associated with the retrograde flow of stomach contents seen in geriatric patients?

    <p>Burning sensations in the retrosternal area</p> Signup and view all the answers

    Where in the gastrointestinal tract does functional dyspepsia primarily originate?

    <p>Upper abdomen</p> Signup and view all the answers

    What is a primary risk factor contributing to peptic ulcer disease (PUD)?

    <p>Long-term NSAID use</p> Signup and view all the answers

    Which symptom is least likely to indicate the presence of small intestine bacterial overgrowth (SIBO)?

    <p>Weight gain</p> Signup and view all the answers

    In diagnosing carbohydrate malabsorption, which of the following hydrogen breath test results indicates malabsorption?

    <p>Rise greater than 20 ppm over baseline</p> Signup and view all the answers

    Which of the following tests has the highest sensitivity for diagnosing Crohn's disease?

    <p>Endoscopy</p> Signup and view all the answers

    What is a common management strategy for patients diagnosed with IBS?

    <p>Diet modification</p> Signup and view all the answers

    Which of the following additional complications is associated with untreated Crohn's disease?

    <p>Deep vein thrombosis</p> Signup and view all the answers

    What factor is most frequently linked to the development of melena in peptic ulcer disease?

    <p>Bleeding ulcers</p> Signup and view all the answers

    Which factor demonstrates the highest likelihood ratio for detecting lactose intolerance in breath testing?

    <p>Hydrogen rise after 60 minutes</p> Signup and view all the answers

    Which dietary modification is typically recommended for managing carbohydrate malabsorption?

    <p>Reduction of specific carbohydrates</p> Signup and view all the answers

    What is the typical age range at which Crohn's disease is most commonly diagnosed?

    <p>20-40 years</p> Signup and view all the answers

    Which of the following statements best describes the management of orthorexia nervosa?

    <p>Patient education is vital to address food fixation and rigid rules.</p> Signup and view all the answers

    What underlying framework is critical for recognizing orthorexia nervosa in patients?

    <p>Eating disturbance exceeding expectations based on concurrent medical conditions.</p> Signup and view all the answers

    Which of the following is a potential consequence of unaddressed orthorexia nervosa?

    <p>Nutrient deficiencies and malnutrition.</p> Signup and view all the answers

    What is a common characteristic of patients diagnosed with chronic diarrhea?

    <p>Potential psychological factors impacting digestion.</p> Signup and view all the answers

    In clinical assessments of IBS, which of the following could be a critical factor?

    <p>The presence of psychosocial stressors impacting symptoms.</p> Signup and view all the answers

    Which condition is characterized by retrograde flow of stomach acid into the esophagus, resulting in inflammation?

    <p>Gastroesophageal reflux disease (GERD)</p> Signup and view all the answers

    Which symptom is most strongly associated with peptic ulcer disease?

    <p>Epigastric pain with food</p> Signup and view all the answers

    What symptom is least likely to be associated with functional dyspepsia?

    <p>Chronic diarrhea</p> Signup and view all the answers

    Which of the following symptoms must be present for at least 3 months to meet the ROME IV criteria for functional dyspepsia?

    <p>Early satiety</p> Signup and view all the answers

    What is the most significant risk factor for developing peptic ulcer disease?

    <p>Long-term NSAID use</p> Signup and view all the answers

    Which dietary factor is most likely to exacerbate symptoms of GERD?

    <p>Spicy foods</p> Signup and view all the answers

    What is one potential complication of untreated small intestine bacterial overgrowth (SIBO)?

    <p>Malnutrition</p> Signup and view all the answers

    In the context of chronic gastrointestinal conditions, which factor is the least significant in the progression of irritable bowel syndrome (IBS)?

    <p>Age at onset</p> Signup and view all the answers

    Which diagnostic tool is most commonly used to confirm carbohydrate malabsorption?

    <p>Hydrogen breath test</p> Signup and view all the answers

    What is the typical age range for diagnosing Crohn's disease?

    <p>20-40 years</p> Signup and view all the answers

    Which underlying condition contributes to an increased risk of developing chronic diarrhea?

    <p>Celiac disease</p> Signup and view all the answers

    How is the diagnosis of IBS commonly confirmed?

    <p>Exclusion of other conditions</p> Signup and view all the answers

    What is a common symptom of lactose intolerance, which is a form of carbohydrate malabsorption?

    <p>Abdominal bloating</p> Signup and view all the answers

    Which laboratory finding has the highest sensitivity for detecting Crohn's disease?

    <p>Fecal calprotectin</p> Signup and view all the answers

    Which medication class is commonly associated with the exacerbation of peptic ulcer disease?

    <p>NSAIDs</p> Signup and view all the answers

    Study Notes

    Eating Disorders Overview

    • Adolescents (ages 12-25) with comorbid psychiatric disorders, especially depression, are at risk for developing eating disorders.
    • Common physical signs include thin appearance, marked weight loss, amenorrhea, and unusual hair and nail brittleness.
    • Other symptoms may involve arrhythmia, bradycardia, edema, hyperkeratosis, hypotension, lanugo, and early onset osteoporosis.

    Diagnosis of Anorexia Nervosa

    • Diagnosis relies on history, DSM-5 criteria, and Body Mass Index (BMI).
    • Urine analysis evaluates hydration status and kidney function, measuring specific gravity, pH, ketones, and protein.
    • Additional tests include monitoring body temperature, performing ECG, and conducting blood tests (CBC, electrolytes).
    • Bone density assessment is critical to checking for osteoporosis.

    Management of Anorexia Nervosa

    • Managed by a collaborative care team including family, psychotherapy, and medical professionals (MD).

    Prognosis for Anorexia Nervosa

    • Approximately 50% achieve full remission, 30% partial remission, and 20% remain chronically ill.
    • Mortality risk is 5.9 times greater compared to the general population.

    Anorexia Nervosa DSM-5 Diagnostic Criteria

    • Restriction of energy intake leading to significantly low body weight relative to age, sex, and physical health.
    • Intense fear of gaining weight or becoming fat, despite being underweight.
    • Disturbance in body image, self-evaluation influenced unduly by weight or shape.

    Bulimia Nervosa Overview

    • Characterized by recurrent binge eating episodes followed by inappropriate compensatory behaviors.
    • Typical behaviors include self-induced vomiting, laxative misuse, fasting, or excessive exercise to prevent weight gain.

    Bulimia Nervosa DSM-5 Diagnostic Criteria

    • Binge eating episodes involve eating a larger portion of food within a discrete time period, accompanied by lack of control.
    • Occurs at least once a week for three months and does not occur exclusively during anorexia episodes.
    • Severity classification ranges from mild (1-3 episodes/week) to extreme (14+ episodes/week).

    Management and Prognosis for Bulimia Nervosa

    • Managed by a collaborative care team involving psychotherapy and psychiatric support.
    • Recovery rates show 50-70% will improve or recover; however, the risk of suicide is increased by 4-7 times.

    Binge-Eating Disorder Overview

    • Defined by recurrent episodes of consuming large portions of food within a short time (≤2 hours), at least once a week for three months.
    • Most prevalent in females, adolescents, and individuals who are overweight or obese.

    Diagnosis of Binge-Eating Disorder

    • Based on history and DSM-5 criteria focusing on the frequency of binge-eating episodes.

    Management and Prognosis for Binge-Eating Disorder

    • Collaborative care involving psychotherapy and medical professionals is employed.
    • High resolution rate of 90% within five years, but 18% may continue to experience clinical eating disorders.
    • Increased risk of obesity is associated with this disorder.

    Binge-Eating DSM-5 Diagnostic Criteria

    • Episodes marked by lack of control over eating and associated symptoms such as rapid eating, eating until uncomfortably full, and eating in isolation due to embarrassment.
    • Distress regarding binge eating is also a significant component of the diagnosis.

    Helicobacter pylori and Peptic Ulcer Disease (PUD)

    • H.pylori is a bacterium linked to the development of peptic ulcers, affecting 90% of small intestines and 60% of stomachs in infected individuals.
    • NSAID usage poses a 6X increased risk for developing ulcers, with 15-25% of dyspepsia patients experiencing PUD.
    • Symptoms include epigastric pain (often related to food), dyspepsia, nausea/vomiting, loss of appetite, and melena (black tarry stools).
    • Diagnosis typically involves upper endoscopy, and management may require antibiotics, antacids, or referral to a specialist.
    • Most cases resolve, but there is potential for ulceration or gastric carcinoma.

    Carbohydrate Malabsorption/Intolerance

    • Condition results from inadequate digestion or absorption of carbohydrates, often due to missing intestinal enzymes.
    • Symptoms include abdominal pain, bloating, watery stools, and excessive gas, often exacerbated by age or high carbohydrate diets.
    • Diagnosis can involve a hydrogen breath test, where a significant rise in hydrogen levels indicates malabsorption.
    • Management focuses on dietary modifications and patient education, with congenital enzyme deficiencies progressing over time.

    Small Intestine Bacterial Overgrowth (SIBO)

    • Characterized by excessive bacteria in the small intestine, with a prevalence of about 15% in the general population, escalating to 40% in IBS patients.
    • Symptoms can vary, including abdominal pain, bloating, diarrhea, or constipation.
    • Diagnosis may include breath tests, indicating SIBO through an increase in hydrogen after specific carbohydrate ingestion.
    • Management may involve antibiotic treatment, and if untreated, chronic SIBO can lead to severe complications like malnutrition and intestinal failure.

    Crohn's Disease

    • A chronic inflammatory condition affecting the gastrointestinal tract, prevalent in 0.35% of the Canadian population, typically diagnosed in individuals aged 20-40.
    • Genetic factors (like NOD2/CARD15 mutations) and risk factors such as smoking and NSAID use can heighten susceptibility.
    • Symptoms include diarrhea, abdominal pain, weight loss, and fatigue, along with extraintestinal manifestations like anemia and osteoporosis.
    • Diagnosed through ileocolonoscopy with biopsy and cross-sectional imaging; management often involves specialist referral and monitoring.
    • Increased risk for various cancers and other health complications if left untreated.

    Bile Acid Malabsorption

    • Diarrhea resulting from excess bile acid production or malabsorption in the terminal ileum.
    • Conditions like Crohn's disease, pancreas insufficiency, or post-cholecystectomy can contribute to this issue.
    • Symptoms encompass persistent diarrhea, increased stool urgency, flatulence, and abdominal pain.
    • Diagnosis can be made through SeHCAT testing or serum assays; treatment may require bile acid sequestrants.

    Clostridioides Difficile-Associated Diarrhea

    • Associated with infections from bacteria, commonly linked to antibiotic use and often occurring in healthcare settings.
    • Symptoms range from mild diarrhea to severe colitis, with potential complications such as significant dehydration or fever.
    • Diagnosis typically involves a history of recent antibiotic use and specific serologic tests.
    • Management includes hydration support and discontinuation of the antibiotic if possible, with a recurrence rate of 13-50%.

    Celiac Disease

    • An autoimmune condition triggered by gluten in genetically predisposed individuals, affecting about 1% of Canadians, especially females.
    • Symptoms can be diverse, including gastrointestinal distress and malnutrition-related deficiencies.
    • Diagnosis relies on serologic testing for specific antibodies and small bowel biopsy.
    • Strict gluten avoidance is crucial for management, with a risk for increased cancers and nutrient deficiencies if untreated.

    Non-Celiac Gluten Sensitivity

    • Occurs in the absence of celiac disease but demonstrates gluten-related symptoms in about 0.5-13% of the population.
    • Symptoms include bloating, abdominal discomfort, fatigue, and other non-intestinal complaints.
    • Diagnosis often utilizes a gluten challenge, while treatment focuses on dietary avoidance and patient education.

    Disordered Eating

    • Includes various eating disorders such as anorexia nervosa, bulimia nervosa, binge-eating disorder, orthorexia, and others, each with unique characteristics and treatment needs.
    • Encouragement for seeking help, with resources like the National Eating Disorder Information Centre available for support.
    • GERD (Gastroesophageal Reflux Disease) characterized by heartburn, sour taste, dysphagia; symptoms include chronic cough, nausea, sore throat, and hoarseness.
    • Diagnosis made through symptom assessment, endoscopy, esophageal pH testing; a therapeutic challenge may involve a PPI trial resulting in a 50% symptom reduction.
    • Up to 23% of GERD patients may develop esophageal strictures; 10-15% may progress to Barrett’s Esophagus after 5-10 years.
    • Barrett’s Esophagus involves metaplastic changes in the esophageal lining, with 2-7% prevalence in Canada; risk factors include long-standing GERD, male gender, age over 50, smoking, obesity, and family history.
    • Diagnosis via endoscopy and biopsy; management involves referral to a specialist and endoscopic surveillance every 3 years.

    Gastritis

    • Inflammation of the stomach lining caused by excess gastric acid; can be erosive (severe) or non-erosive (atrophic/metaplastic).
    • Risk factors include H. pylori infection, NSAID use, alcohol, and stress; may coexist with GERD.
    • Symptoms include epigastric pain, nausea, vomiting, loss of appetite, and melena.
    • Diagnosis confirmed through upper endoscopy; management includes potential referral and treatment with antibiotics and antacids.

    Peptic Ulcer Disease (PUD)

    • Localized erosion of stomach or small intestine mucosa, commonly caused by H. pylori and NSAIDs, with a 15-25% prevalence in dyspeptic patients.
    • H. pylori found in up to 90% of small intestine cases and 60% in stomach cases; NSAIDs increase risk.
    • Symptoms frequently include abdominal pain and discomfort.

    Carbohydrate Malabsorption

    • Inability to digest certain carbohydrates due to lack of intestinal enzymes, leading to symptoms like abdominal pain and bloating.
    • Diagnosis confirmed via hydrogen breath test; a significant rise in breath hydrogen indicates malabsorption.
    • Management focuses on dietary modifications; congenital enzyme deficiencies may worsen with age.

    Small Intestine Bacterial Overgrowth (SIBO)

    • Presence of excessive bacteria in the small intestine, affecting approximately 15% of the general population and 40% of IBS patients.
    • Symptoms include abdominal pain, bloating, and diarrhea or constipation.
    • Management may involve antibiotics; untreated SIBO can lead to malnutrition and intestinal failure.

    Crohn’s Disease

    • Chronic inflammatory disease mainly affecting the gastrointestinal tract; increasing prevalence in Canada, especially among ages 20-40.
    • Associated with genetic risks (e.g., NOD2/CARD15), smoking, and previous antibiotic use.
    • Symptoms include diarrhea, abdominal pain, rectal bleeding, fatigue, and various systemic issues including anemia and osteoporosis.
    • Diagnosis requires (ileo)colonoscopy with biopsy; management typically involves gastroenterologist referral.

    Bile Acid Malabsorption

    • Characterized by recurrent upper abdominal pain or discomfort, affecting about 30% of North Americans.
    • Symptoms include early satiety and postprandial fullness; ROME IV criteria diagnose based on symptom presence and absence of structural disease.

    Diagnostic Testing Insights

    • Fecal calprotectin test shows high sensitivity (83-100%) for Crohn’s.
    • Breath hydrogen tests for carbohydrate absorption issues have varied sensitivity for different sugars (e.g., lactose: 95%, fructose: 98%).
    • PPI trial for GERD has sensitivity of 79% with a positive likelihood ratio of 5.5.

    Prognosis and Complications

    • Most gastric conditions, including gastritis and mild PUD, tend to resolve but can lead to severe complications like ulcers or cancer if untreated.
    • Barrett’s Esophagus has a low conversion risk to esophageal adenocarcinoma (<1%) but requires surveillance due to long-term risk factors.

    Peptic Ulcer Disease (PUD)

    • Localized erosion in the mucosal layer of the stomach or small intestine.
    • Present in 15-25% of dyspepsia patients; Helicobacter pylori and NSAID use increase risk by 6 times.
    • H. pylori found in 90% of small intestine cases and 60% of stomach cases.
    • NSAIDs associated with 7% in small intestine and 35% in stomach cases.
    • Symptoms include epigastric pain correlated with food intake, dyspepsia, nausea and vomiting, loss of appetite, and melena.
    • Diagnosis through upper endoscopy.
    • Management may require referral to a medical doctor for antibiotics, antacids (H2 blockers, PPIs).
    • Prognosis: Most cases resolve, but there is a risk of ulceration or gastric carcinoma.

    Carbohydrate Malabsorption/Intolerance

    • Inability to digest certain carbohydrates due to lack of intestinal enzymes.
    • Symptoms include abdominal pain, bloating, excessive gas, and watery stools.
    • Commonly affected carbohydrates: lactose and fructose, particularly in older adults and those consuming high amounts of dairy and fruit.
    • Diagnosis can be confirmed with a hydrogen breath test revealing a rise in breath hydrogen concentration greater than 20 ppm after carbohydrate ingestion.
    • Management involves patient education regarding dietary modifications.
    • Congenital enzyme deficiencies may worsen with age.

    Small Intestine Bacterial Overgrowth (SIBO)

    • Characterized by excessive bacteria in the small intestine, exceeding 10^5-10^6 organisms/mL.
    • 15% prevalence in the general population; 40% in IBS patients.
    • Risk factors: history of travel-related diarrhea, food poisoning, frequent antibiotic use, prolonged PPI use, and prior cholecystectomy.
    • Symptoms include abdominal pain, bloating, diarrhea (hydrogen dominant) or constipation (methane dominant).
    • Diagnosis via breath tests reflecting a rise in breath hydrogen concentration after carb ingestion.
    • Management may require antibiotic treatment or referral to a physician.
    • Prognosis: Untreated SIBO can lead to severe complications like weight loss, malnutrition, and recurrence rates up to 44%.

    Crohn's Disease

    • Chronic inflammation affecting the gastrointestinal tract, potentially leading to extraintestinal complications.
    • Prevalence in the Canadian population is 0.35%, typically diagnosed between ages 20-40.
    • Associated genetic risk: homozygous for NOD2/CARD15 increases risk 20-40 folds.
    • Symptoms include diarrhea, cramping abdominal pain, rectal bleeding, fever, and weight loss.
    • Extraintestinal manifestations may include anemia, osteoporosis, and various inflammatory conditions.
    • Diagnosis involves ileocolonoscopy with biopsy, imaging tests, and fecal markers.
    • Management often requires referral to a gastroenterologist.
    • Prognosis: Increased risk for several cancers, nutritional deficiencies, and thrombotic events.

    Hydrogen Breath Testing for Carbohydrate Malabsorption and SIBO

    • Procedures involve serial breath sampling after carbohydrate ingestion.
    • An increase in breath hydrogen concentration greater than 20 ppm indicates malabsorption in both conditions.
    • Lactose testing has 95% sensitivity; fructose testing shows 98% sensitivity.
    • Glucose testing for SIBO has a sensitivity of 62%, while lactulose ranges from 31-68%.

    Gastroesophageal Reflux Disease (GERD)

    • Involves retrograde flow of stomach acid into the esophagus, causing inflammation and discomfort.
    • Affects up to 35% of the general population.
    • Risk factors include obesity, smoking, alcohol, certain foods (chocolate, peppermint, spicy, citrus), and carbonated beverages.
    • Symptoms manifest as retrosternal or epigastric burning pain post meals (pyrosis).

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    Description

    This quiz covers an overview of eating disorders, focusing particularly on anorexia nervosa. It explores the physical signs, diagnostic criteria, management strategies, and the important role of a collaborative care team. Enhance your understanding of the complexities surrounding these disorders.

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