Enteric feeding in severe adolescent anorexia nervosa: A report of four cases

Objective: Refeeding patients with anorexia nervosa can be one of the more challenging aspects of their treatment, and particularly if all food and fl uids are adamantly and persistently refused. Method: If the decision is mad e to augment or replace oral feeds, the most common intervention is nasogas tric feeding. Results: Although this is often successful, a subset of patie nts manage to sabotage feeding via this route. Other means of delivering nu trition such as intravenous feeds are often impractical for long-term use. Another alternative in such life-threatening situations is the use of enter ic feeds via gastrostomy or jejunostomy. This paper presents the successful use of such enteric feeding in four cases of severe adolescent anorexia ne rvosa. Discussion: The psychological, legal, and ethical issues involved ar e discussed, concluding that gastrostomy and jejunostomy are valid lifesavi ng methods to feed highly resistant anorectic patients. (C) 2000 by John Wi ley & Sons, Inc.