Objectives:The low FODMAPs diet has emerged as an option for the treatment of irritable bowel syndrome (IBS). One major challenge of this diet is that it is very restrictive, and compliance is usually low. Preliminary findings suggest an association between eating disorder (ED) and the risk of developing IBS. The primary aim of the study is to assess the correlation between compliance to low FODMAPs diet and risk of eating disorder behaviours among an irritable bowel syndrome cohort. Methods:We report a single centre study in the IBS patient population at University College London Hospital (UCLH). 233 patients (186 female) who commenced a low FODMAPs group programme for IBS (Rome III or IV). Self-reported diet adherence at the end of the 6week programme was measured. At baseline, participants completed the SCOFF questionnaire (a validated 5-item screening tool for EDs), the validated HADS questionnaire and the validated IBS-symptom severity score (IBS-SSS). Results:The SCOFF questionnaire identified 54 (23%) patients at an increased risk of ED behaviour. Overall, 95 (41%) participants were diet-adherent at 6 weeks, with significantly greater adherence in identified ED individuals (57%). The highest adherence rate (51%) was in the IBS-D subtype and the lowest rate (10%) in IBS-C. There was no significant relationship between IBS symptom severity and either adherence or ED severity. Conclusion:In our IBS patient cohort greater adherence to a low FODMAPs diet is associated with eating disorder behaviour. The implications of our study are for clinicians to have a high index of suspicion of EDs in IBS patients, but also that low FODMAPs dietary advice to the general IBS population should be couched alongside psychological support.
Background. Symptoms of celiac disease negatively impact social activities and emotional state. Aim was to investigate the prevalence of altered eating behaviour in celiac patients. Methods. Celiac patients and controls completed a dietary interview and the Binge Eating Staircases, Eating Disorder Inventory (EDI-2), Eating Attitudes Test, Zung Self-Rating Depression Scale, State Trait Anxiety Inventory Forma Y (STAI-Y1 and STAI-Y2), and Symptom Check List (SCL-90). Results. One hundred celiac adults and 100 controls were not statistically different for gender, age, and physical activity. STAI-Y1 and STAI-Y2, Somatization, Interpersonal, Sensitivity, and Anxiety scores of the SLC-90 were higher in CD patients than controls. EDI-2 was different in pulse thinness, social insecurity, perfectionism, inadequacy, ascetisms, and interpersonal diffidence between CD and HC women, whilst only in interceptive awareness between CD and HC men. A higher EAT-26 score was associated with the CD group dependently with gastrointestinal symptoms. The EAT26 demonstrated association between indices of diet-related disorders in both CD and the feminine gender after controlling for anxiety and depression. Conclusion. CD itself and not gastrointestinal related symptoms or psychological factors may contribute pathological eating behavior in celiac adults. Eating disorders appear to be more frequent in young celiac women than in CD men and in HC.
Long-term continuation of TAI, with improved bowel symptomatology, is seen in the majority of patients. The EQ-5D is insufficiently sensitive to show change in MS patients that using TAI.
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