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

OBJECTIVE: Research 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. METHODS: A 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. RESULTS: Fourteen articles were included, encompassing 219 cases, including ours. The vast majority were females ranging from 10 to 44years 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. CONCLUSION: Recent 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.

Interpositional polytetrafluoroethylene grafts. Conjunctival biocompatibility.

Polytetrafluoroethylene (PTFE) is a synthetic, woven, nonabsorbable, nonantigenic, Teflon-related material that has been shown to be useful in correcting eyelid retraction and as an implant enveloping material in primary and secondary surgery to correct anophthalmos. Implanted PTFE will extrude if not entirely covered with a layer of conjunctival epithelium. In vitro studies demonstrated that coating PTFE with collagen, fibronectin, gelatin, or laminin promotes epithelial cell and fibroblast migration over and adherence to PTFE. In vivo studies showed that a coating of type 1 collagen is most successful in preventing graft extrusion by promoting conjunctival epithelial attachment and growth over exposed PTFE. Further studies are needed to determine the optimum PTFE coating and pore size needed to ensure the consistent retention of uncovered implanted PTFE grafts.

Polytetrafluoroethylene as an interpositional graft material for the correction of lower eyelid retraction.

Polytetrafluoroethylene (PTFE), a nonantigenic, autoclavable, inert, woven synthetic graft material was used to correct ten lower eyelids with retraction secondary to either thyroid disease (7 eyelids) or surgically repaired maxillofacial trauma (3 eyelids). The material was well tolerated for postoperative periods ranging from 10 to 26 months. In two eyelids, a portion of the PTFE was removed to treat eyelid thickening and an infected meibomian gland. Results of histopathologic examination of the graft showed minimal inflammation and capillary and connective ingrowth into the graft matrix as well as a dense fibrous capsule around the graft. In selected cases, PTFE may be an acceptable substitute for other graft materials used in oculoplastic surgery.