Irritable bowel syndrome and functional dyspepsia in patients with eating disorders ‐ a systematic review

Abstract

Objectives: The prevalence of eating disorders is rising worldwide. The low body weight in anorexia nervosa as well as the increase in body mass index due to binge eating disorder are contributing to a strikingly high morbidity and mortality. In a similar pattern, the prevalence and burden of the disease of functional gastrointestinal disorders such as functional dyspepsia and irritable bowel syndrome is increasing. As gastrointestinal complaints are commonly reported by patients with eating disorders, the question arose whether there is a relationship between eating disorders and functional gastrointestinal disorders.Methods: To address the need to better understand the interplay between eating disorders and functional gastrointestinal disorders as well as factors that might influence this connection, the data bases Medline, Web of Science and Embase were systematically searched.Results: After removal of duplicates the search yielded 388 studies which were screened manually. As a result, 36 publications were selected for inclusion in this systematic review. Conclusion:The occurrence of functional gastrointestinal disorders like irritable bowel syndrome and functional dyspepsia in patients with eating disorders is considerably high and often associated with psychological, hormonal and functional alterations. In the future, further research addressing the underlying mechanisms accounting for this relationship is required.

Estrés, depresión, ansiedad y el hábito alimentario en personas con síndrome de intestino irritable

“…A la vez, no hallaron una asociación significativa entre el subtipo de SII y la puntuación de EAT (p > 0,05). Sin embargo, la intensidad y la duración del SII presentaron una correlación positiva con las puntuaciones de EAT, lo que justifica algunos comentarios de otros autores en los que se vincula la presencia de SII con alimentación desordenada e incluso con trastornos alimenticios como anorexia nerviosa, bulimia y trastornos no especificados (44) .…”

Assessment and management of disorders of gut–brain interaction in patients with eating disorders

“…Patients with DGBI often have eating-related concerns, and there is growing recognition of the relevance of DGBI symptoms to eating disorders (EDs). Both EDs and DGBIs lie at the interface of the brain-gut connection, with input from biological, psychological, and social factors [ 3 , 4 ].…”

“…Patients with EDs frequently present with GI complaints, with patients with avoidant/restrictive food intake disorder (ARFID) showing particularly disproportionate GI symptom burden [ 13 , 14 ]. In inpatient and outpatient ED settings, DGBI rates range from 39% and up to 98% [ 4 , 15 ]. EDs may induce DGBI—while retrospectively reported, one study in irritable bowel syndrome (IBS) found that ED symptoms preceded IBS diagnosis for the majority (87%) of patients [ 16 ].…”

“…delayed emptying of the stomach, delayed colonic transit time) improves with refeeding [ 3 ]. However, other research has shown no association between DGBI and weight status (such as by body mass index (BMI)) [ 4 ]. Moreover, features of DGBI, such as bloating and distension, are present in equal frequencies across disparate ED phenotypes [ 21 , 22 ].…”

Carbohydrate malabsorption in anorexia nervosa: a systematic review

“…The metabolism and digestion can be severely impacted by AN which leads to gastrointestinal (GI) complaints like postprandial distress or distension of the abdomen and stomach due to slow gastric motility [ 4 ] which could—at least in part—further contribute to the low food intake of these patients [ 5 ]. In addition, functional GI disorders are frequent in patients with AN [ 6 ]. Lastly, subjects with AN may eat less of a regularly composed meal but tend to choose foods with low energy density, fewer calories, but large volume, for example fruits and vegetables or settle on a vegetarian diet with a higher amount of carbohydrates than protein or fat [ 7 ].…”