Anorexia?

Question

My 14-year-old son has cystic fibrosis. For the last three weeks, after a gastroenteritis, he has been refusing to eat, suffering from recurring stomach aches, and he vomits if forced to eat. His weight is 47 kg for 1.72 m. His doctors consider a psychological factor as the most likely hypothesis (and he is under a child psychiatrist’s care): However, I’m still strongly worried by the stomach aches and the vomiting. Could this have something to do with anorexia? Or something else?
Thank you for your help. I am really distraught by him being so skinny and refusing to eat.

Answer

Dear Madam,
Faced with the symptoms displayed by your son, it appears that you are wondering whether it may be anorexia. In fact, in the medical language, ‘anorexia’ simply refers to a lack of appetite, and of course, this symptom may have various causes. Among these causes, psychological difficulties is an hypothesis worth considering, since such difficulties often lead to digestive troubles comparable to those you describe. However, it is essential to check first that there is no organic cause involved. The characteristics of the pain, the medical examination, and further examinations, have probably led your son’s doctors to rule out some hypothesis, such as gastritis, ulcer, pancreatitis, distal intestinal obstructive symdrome (DIOS)…
You are also worried by the low weight of your son. Indeed, keeping a good nutritional status is important in cystic fibrosis. But forcing an adolescent to eat is never a good thing. One can try proposing more frequent but smaller meals, with the most-tolerated aliments, while always being sure of maintaining a good hydration.
Whatever, having talks with the doctors at your care center is essential. Don’t hesitate to let them know about your anxiety, which is legitimate. They will explain you the examinations, performed or scheduled, will accompany you, with the help of the dietetician, towards a solution to your son’s anorexia, and will keep a vigilant eye on the improvement of your son’s symptoms and weight.
Sincerely,
Dr Michèle Gérardin

05.05.2011