Prevalence of functional dyspepsia and its subgroups in patients with eating disorders

Santonicola, Antonella; Siniscalchi, Mario; Capone, P.; Gallotta, S.; Ciacci, Carolina; Iovino, Paola

doi:10.3748/wjg.v18.i32.4379

Cited by 54 publications

(77 citation statements)

References 30 publications

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“…The most widely used generic measure, the Short Form 36-Item Health Survey (SF-36) 222 , assesses eight dimensions of health: physical functioning, social functioning, Nature Reviews | Disease Primers Fatty foods , milk and dairy Alcohol , coffee Red meat Carbonated drinks Vegetables Spicy foods Carbohydrates and wheat (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) Citrus (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) Figure 5 | Foods and food groups frequently associated with symptom induction or exacerbation in functional dyspepsia. Offending foods reported by patients with functional dyspepsia include fatty food (for example, fried food [179][180][181]187,191 ), alcohol 179,180 , dairy products 179,181 , coffee [179]…”

Section: Quality Of Lifementioning

confidence: 99%

“…As a consequence of the low prevalence of primary psychiatric disorder, the use of psychotherapy to manage functional dyspepsia is less often attempted (see Psychotherapy, below) and less effective in general than in IBS 40 . Psychiatric comorbidities that are much more prevalent in functional dyspepsia (in particular in PDS) than in IBS are eating disorders (for example, bulimia or anorexia nervosa) 41,42 and, therefore, it is necessary to first exclude a primary eating disorder in patients who present with functional dyspepsia symptoms and weight loss.Health economic data indicate that functional dyspepsia has high direct and indirect costs, specifically driven by the high prevalence of comorbidity 18,43 , but both organic dyspepsia and functional dyspepsia have similar economic effects 44 . …”

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confidence: 99%

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Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

253

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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Section: Quality Of Lifementioning

confidence: 99%

mentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

253

247

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show abstract

“…At the other extreme, many morbidly underweight patients with anorexia nervosa complain of prolonged fullness, bloating and nausea after meals [22]. These sensations have been linked to abnormal stomach function [23–26] – in particular, prolonged gastric emptying [25, 27–32].…”

Section: Introductionmentioning

confidence: 99%

Relationship of body weight with gastrointestinal motor and sensory function: studies in anorexia nervosa and obesity

Bluemel

Menne²,

Milos

et al. 2017

BMC Gastroenterol

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BackgroundWhether gastrointestinal motor and sensory function is primary cause or secondary effect of abnormal body weight is uncertain. Moreover, studies relating continuous postprandial sensations of satiation to measurable pathology are scarce. This work assessed postprandial gastrointestinal function and concurrent sensations of satiation across a wide range of body weight and after weight change.MethodsPatients with anorexia nervosa (AN) and obesity (OB) were investigated in reference to normal weight controls (HC). AN were additionally investigated longitudinally. Gastric emptying, antral contractions and oro-cecal transit after ingestion of a solid meal were investigated by MRI and 13C-lactose-ureide breath test. The dependency of self-reported sensations of satiation on the varying degree of stomach filling during gastric emptying was compared between groups.Results24 AN (BMI 14.4 (11.9–16.0) kg/m2), 16 OB (34.9 (29.6–41.5) kg/m2) and 20 HC (21.9 (18.9–24.9) kg/m2) were studied. Gastric half-emptying time (t50) was slower in AN than HC (p = 0.016) and OB (p = 0.007), and a negative association between t50 and BMI was observed between BMI 12 and 25 kg/m2 (p = 0.007). Antral contractions and oro-cecal transit were not different. For any given gastric content volume, self-reported postprandial fullness was greater in AN than in HC or OB (p < 0.001). After weight rehabilitation, t50 in AN tended to become shorter (p = 0.09) and postprandial fullness was less marked (p < 0.01).ConclusionsA relationship between body weight and gastric emptying as well as self-reported feelings of satiation is present. AN have slower gastric emptying and heightened visceral perception compared to HC and OB. Longitudinal follow-up after weight rehabilitation in AN suggests these abnormalities are not a primary feature, but secondary to other factors that determine abnormal body weight.Trial registrationRegistered July 20, 2009 at ClinicalTrials.gov (NCT00946816).Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0560-y) contains supplementary material, which is available to authorized users.

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“…In 1994, Sullivan et al [72] indicated that about 40% of bloating complainers gained weight concurrently to the onset of symptoms and, in 2001, Chang et al [11] found that 24% of patients believed that their bloating symptoms began when weight started to increase. In our experience massive obese patients on a waiting list prior to bariatric surgery do not have a significant increase in intensity-frequency scores of bloating and flatulence compared to controls [34] . Thus one can speculate that the recent fat accumulation in the abdomen, not massive obesity as chronic condition may favor the development or awareness of bloating as a symptom.…”

Section: Liquidsmentioning

confidence: 93%

“…Increased air swallowing, however, is either not or rarely observed in IBS patients [33] . Although not covered in this review, eating disorders may also be associated with symptoms of gas and bloating [34] . Moreover, it has been shown that some food components in the normal diet, such as resistant starch, oligosaccharides and plant fibres, are incompletely absorbed in the small bowel and enter the colon [35] with subsequent fermentation, and secondary bacterial overgrowth with abnormal fermentation of foodstuffs within the small bowel or hyperactive colonic microflora.…”

Section: Increased Luminal Contentsmentioning

confidence: 99%

Bloating and functional gastro-intestinal disorders: Where are we and where are we going?

Iovino

Bucci

Tremolaterra

et al. 2014

WJG

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Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such as sensation of a distended abdomen or an abdominal tension or even excessive gas in the abdomen, although bloating should probably be defined as the feeling (e.g. a subjective sensation) of increased pressure within the abdomen. It is usually associated with functional gastrointestinal disorders, like irritable bowel syndrome, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome Ⅲ criteria named functional bloating. In terms of diagnosis, major difficulties are due to the lack of measurable parameters to assess and grade this symptom. In addition, it is still unclear to what extent the individual patient complaint of subjective bloating correlates with the objective evidence of abdominal distension. In fact, despite its clinical, social and economic relevance, bloating lacks a clear pathophysiology explanation, and an effective management endorsement, turning this common symptom into a true challenge for both patients and clinicians. Different theories on bloating etiology call into questions an increased luminal contents (gas, stools, liquid or fat) and/or an impaired abdominal empting and/or an altered intra-abdominal volume displacement (abdomino-phrenic theory) and/ or an increased perception of intestinal stimuli with a subsequent use of empirical treatments (diet modifications, antibiotics and/or probiotics, prokinetic drugs, antispasmodics, gas reducing agents and tricyclic antidepressants). In this review, our aim was to review the latest knowledge on bloating physiopathology and therapeutic options trying to shed lights on those processes where a clinician could intervene to modify disease course. Key words: Bloating; Functional gastro-intestinal disorders; Irritable bowel syndrome; Constipation; Diarrhea Core tip: Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients, mostly with functional gastrointestinal disorders, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome Ⅲ criteria named functional bloating. Despite its clinical, social and economic Iovino P et al . Bloating and functional gastro-intestinal disorders relevance, bloating lacks a clear pathophysiology explanation and an effective management endorsement. Moreover, it is unclear to what extent subjective complaint of bloating correlates with the objective evidence of abdominal distension. The aim of this paper is to review the latest knowledge on bloating and to explore future research directions to improve its management.

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Prevalence of functional dyspepsia and its subgroups in patients with eating disorders

Abstract: PDS is common in eating disorders. Is it mandatory in outpatient gastroenterological clinics to investigate eating disorders in patients with PDS?

Cited by 54 publications

References 30 publications

Functional dyspepsia

Functional dyspepsia

Relationship of body weight with gastrointestinal motor and sensory function: studies in anorexia nervosa and obesity

Bloating and functional gastro-intestinal disorders: Where are we and where are we going?

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