In patients with EDs, specific psychological traits predict FGID type and the presence of multiple coexistent FGIDs. These findings support the role of specific psychological features as important contributors to certain FGIDs.

BACKGROUND:Accreditation Council on Graduate Medical Education (ACGME) duty hour restrictions have led to the widespread implementation of non–house staff services in academic medical centers, yet little is known about the quality and efficiency of patient care on such services.OBJECTIVE:To evaluate the quality and efficiency of patient care on a physician assistant/hospitalist service compared with that of traditional house staff services.DESIGN:Retrospective cohort study.SETTING:Inpatient general medicine service of a 747‐bed academic medical center.PATIENTS:A total of 5194 consecutive patients admitted to the general medical service from July 2005 to June 2006, including 992 patients on the physician assistant/hospitalist service and 4202 patients on a traditional house staff service.INTERVENTION:A geographically localized service staffed with physician assistants and supervised by hospitalists.MEASUREMENTS:Length of stay (LOS), cost of care, inpatient mortality, intensive care unit (ICU) transfers, readmissions, and patient satisfaction.RESULTS:Patients admitted to the study service were younger, had lower comorbidity scores, and were more likely to be admitted at night. After adjustment for these and other factors, and for clustering by attending physician, total cost of care was marginally lower on the study service (adjusted costs 3.9% lower; 95% confidence interval [CI] −7.5% to −0.3%), but LOS was not significantly different (adjusted LOS 5.0% higher; 95% CI, −0.4% to +10%) as compared with house staff services. No difference was seen in inpatient mortality, ICU transfers, readmissions, or patient satisfaction.CONCLUSIONS:For general medicine inpatients admitted to an academic medical center, a service staffed by hospitalists and physician assistants can provide a safe alternative to house staff services, with comparable efficiency. Journal of Hospital Medicine 2008;3:361–368. © 2008 Society of Hospital Medicine.

ROME III confers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting. Psychological factors appear to be more influential in ROME II than ROME III.

Clinicians assessing eating disordered individuals should address specific exercise feelings, rather than exercise amount or frequency.

Functional gastrointestinal disorders remain common after 12 months in patients with an ED. Considerable turnover of the FGIDs occurs, however, and the appearance of new FGIDs is not restricted to the original FGID regional category. There is no apparent relationship between the turnover of the FGIDs and ED behaviors, psychological variables or body weight change. These findings have implications for the clinical evaluation and management of FGIDs in ED patients.

This quick, simple instrument fulfils all potential uses for QOL assessments in the clinical and research settings associated with eating disorders, including outcome.

When accurate information is required, clinicians should measure height and weight, particularly if the adolescent female is perimenarcheal or appears to differ from population averages for height and weight.

This quick, simple instrument fulfils all potential uses for QOL assessments in the clinical and research settings associated with eating disorders, including outcome.