Open AccessRectal Picking Masquerading as Inflammatory Bowel Disease in Prader‐Willi Syndrome
Author(s) -
Salehi Parisa,
Lee Dale,
Ambartsumyan Lusine,
Sikka Natalie,
Scheimann Ann O.
Publication year - 2018
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000001937
Subject(s) - medicine , choking , constipation , dysphagia , vomiting , gastroenterology , gastric emptying , disease , short bowel syndrome , surgery , parenteral nutrition , stomach , anatomy
Prader‐Willi syndrome (PWS) is a genetic syndrome in which individuals have multisystem medical challenges. Gastroenterological difficulties in the syndrome include decreased vomiting, constipation, delayed gastric emptying, delayed colonic transit, dysphagia, increased choking, and increased risk of gastric dilation and rupture. In addition, self‐injurious behavior such as rectal picking may be present and severe enough to lead to rectal ulceration and bleeding. Many patients have extensive gastroenterological workup and treatment before their ultimate diagnosis of severe rectal picking. We describe 4 new cases of rectal picking in individuals with PWS leading to rectal bleeding and ulceration as well as a review of the literature of prior cases of severe rectal picking in PWS and potential treatment options. It is important to recognize these cases early in order to prevent unnecessary treatments and implement appropriate behavioral interventions.