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首页> 外文期刊>European journal of gastroenterology and hepatology >Unmasking a current medical pretender: anorexia nervosa in gastrointestinal practice.
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Unmasking a current medical pretender: anorexia nervosa in gastrointestinal practice.

机译：揭露当前的医学伪装者：胃肠道实践中的神经性厌食症。

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* Anorexia nervosa (AN) often presents to gastrointestinal clinics with medical symptomatology, especially constipation, but differs in important features by an atypical illness history, unsuccessful past treatments, and parental characteristics.* Failure to recognize AN as the primary cause of gastrointestinal symptoms substantially delays appropriate treatment and greatly increases medical costs while decreasing quality of life for the patient and parents.* Recognition of occult AN as the true cause of gastrointestinal symptoms is easily accomplished and results in successful referral and treatment of the AN.Anorexia nervosa (AN) resembles the 'great pretenders' of medicine in the nineteenth century, syphilis and tuberculosis, by presenting occultly as a disorder of specific organs. Many physicians fail to identify the true primary cause, AN, which can mimic in its medical consequences gastrointestinal disorders, endocrine failure, pituitary tumors, or cancer. This is especially likely when the patients are older, have an established complex medical history, and challenge a specialist to find a medical cause and treatment, resulting in ordering more laboratory tests and medical instrumentation. Everyone suffers as a result, including the patient, the family, the frustrated physician, and the National Health Service, for whom the costs of medical care of these patients are enormous and out of proportion. Remembering that AN is as much a medical as a psychological disorder, assessing the patient with more time and expertise in history taking, and referring to a psychiatric consultant when National Institute for Clinical Excellence guidelines for identifying AN in non-mental health settings trigger suspicions, results in good outcome of the AN, cessation of ineffective gastrointestinal treatments, and substantial savings to the National Health Service.
机译：*神经性厌食症（AN）通常以医学症状，特别是便秘出现在胃肠道诊所，但因非典型病史，过去的治疗失败和父母特征而在重要特征上有所不同。*未能将AN视为是胃肠道症状的主要原因延误了适当的治疗并大大增加了医疗费用，同时降低了患者和父母的生活质量。*隐匿性AN是胃肠道症状的真正原因，这一点很容易实现，并且可以成功地推荐和治疗AN。神经性厌食症（AN）通过隐蔽地表现为特定器官的疾病，类似于19世纪医学上的“伟大假装”，梅毒和肺结核。许多医生未能找出真正的主要病因，AN可以模仿其胃肠道疾病，内分泌衰竭，垂体瘤或癌症的医学后果。当患者年龄较大，具有确定的病史并挑战专家以寻找医疗原因和治疗方法，从而需要更多的实验室测试和医疗仪器时，这种情况尤其可能发生。结果，每个人都遭受了痛苦，包括患者，家庭，沮丧的医生以及国家卫生局，这些患者的医疗费用巨大且不成比例。牢记AN不仅是一种心理疾病，而且在医学上是一样的，他需要花更多的时间和专门知识来评估患者的病史，并在美国国家临床卓越研究所在非精神健康状况下识别AN的准则引发怀疑时，请咨询精神病学顾问，结果可以使AN取得良好的效果，停止无效的胃肠道治疗，并为国家卫生局节省大量资金。

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