Prevalence of Functional Gastrointestinal Disorders according to Rome III Criteria in Italian Morbidly Obese Patients

Abstract

The relationship between GI symptoms and obesity has yet to be completely clarified. Aim. To determine in a morbidly obese southern Italy adult population the prevalence of Functional Gastrointestinal Disorders (FGID) and its association with the presence of a Binge Eating (BE) behavior pattern. Methods. Consecutive obese patients eligible for bariatric surgery and 100 Healthy Controls (HC) were recruited. All participants were questioned and scored for the presence of FGID according to Rome III criteria and for the presence or the frequency-intensity of a number of upper and lower GI symptoms. BE behavior pattern was assessed. Results. One-hundred obese patients met the inclusion criteria. The prevalence of FGID was similar between obese patients and HC. There was a significant association between obese patients with BE behavior and postprandial distress syndrome (P = 0.04). Moreover, a significantly higher frequency-intensity score for epigastric fullness (1.23 ± 0.45 versus 0.35 ± 0.13, P = 0.01) was found in obese patients with BE behavior compared to obese patients without. Conclusions. Obese patients with a BE behavior pattern showed a significantly higher prevalence of postprandial distress syndrome. A greater knowledge of the GI symptoms associated with obesity along with the pathophysiological mechanisms underlying will be important in the clinical management of these patients.

Eating Disorders and Gastrointestinal Diseases

“…We previously reported that the frequency-intensity scores of typical and atypical GERD symptoms did not differ in obese patients with and without a binge eating behavior pattern [61], although it has been extensively demonstrated that obese patients have a high prevalence of GERD [62].…”

“…BED showed a high frequency of lower GI symptoms such as diarrhea (OR 3.1, 95% CI 2.0-4.6), urgency (OR 3.9, 95% CI 2.6-6.1), constipation (OR 2.2, 95% CI 1.2-4.1) and a feeling of anal blockage (OR 2.7, 95% CI 1.5-5.0) [58]. However, another study reported no difference in IBS prevalence, diagnosed on the basis of the Rome III criteria, among obese patients with and without a BE behavior pattern (p = 0.9) [61].…”

“…Crowell et al [81] demonstrated that upper GI symptoms were more common in obese binge eaters than normal controls or obese non-binge eaters. The specific pattern of eating behavior may contribute to the development of these symptoms [61].…”

“…This could cause a reduced response to the signals that lead to meal termination, allowing these patients to continue the binge episodes. Accordingly, PDS was significantly more frequent in OB with a Binge-Eating (BE) behavior pattern compared to OB without a BE behavior pattern [61]. From a physiological point of view, a huge food intake over a relatively short time could potentially impair the functional accommodation and emptying, contributing to the genesis of GI symptoms in obese individuals [39].…”

Functional Gastrointestinal Disorders in Obese Patients. The Importance of the Enrollment Source

“…In fact, independently of the country of origin, previous studies associated BMI and organic or functional digestive disorders in cohort patients from different types of enrollment: functional disease recruitment [28], weight loss programs [29], bariatric surgery [20], endoscopic evaluation [27,30], or epidemiological studies [31,32]. In addition, some studies could include control groups [33] but did not separate obese patients according to their BMI [34]. However, the meta-analyses previously published did not take into account the presence of recruitment bias for GERD [35][36][37][38], pelvic floor symptoms [39], or all the FGIDs [40].…”