Avoidant/restrictive food intake disorder prevalence is high in children with gastroparesis and functional dyspepsia

Abstract

BackgroundAvoidant/restrictive food intake disorder (ARFID) prevalence in children with gastroparesis (Gp) and/or functional dyspepsia (FD) is unknown. We aimed to identify ARFID prevalence and trajectory over 2 months in children with Gp, FD, and healthy children (HC) using two screening questionnaires. We also explored the frequency of a positive ARFID screen between those with/without delayed gastric emptying or abnormal fundic accommodation.MethodsIn this prospective longitudinal study conducted at an urban tertiary care hospital, patients ages 10–17 years with Gp or FD and age‐ and gender‐matched HC completed two validated ARFID screening tools at baseline and 2‐month follow‐up: the Nine Item ARFID Screen (NIAS) and the Pica, ARFID, and Rumination Disorder Interview‐ARFID Questionnaire (PARDI‐AR‐Q). Gastric retention and fundic accommodation (for Gp and FD) were determined from gastric emptying scintigraphy.Key ResultsAt baseline, the proportion of children screening positive for ARFID on the NIAS versus PARDI‐AR‐Q was Gp: 48.5% versus 63.6%, FD: 66.7% versus 65.2%, HC: 15.3% versus 9.7%, respectively; p < 0.0001 across groups. Of children who screened positive at baseline and participated in the follow‐up, 71.9% and 53.3% were positive 2 months later (NIAS versus PARDI‐AR‐Q, respectively). A positive ARFID screen in Gp or FD was not related to the presence/absence of delayed gastric retention or abnormal fundic accommodation.Conclusions & InferencesARFID detected from screening questionnaires is highly prevalent among children with Gp and FD and persists for at least 2 months in a substantial proportion of children. Children with these disorders should be screened for ARFID.

Assessing avoidant/restrictive food intake disorder symptoms using the Nine Item ARFID Screen in >9,000 Swedish adults with and without eating disorders

“…A large number of translations and adaptations of the NIAS have been made (e.g., Billman Miller et al, 2024;Fekih-Romdhane et al, 2023;He et al, 2021;Medina-Tepal et al, 2023;Van Ouytsel et al, 2024;Ziolkowska et al, 2022), including development of a parent-report version (Ziolkowska et al, 2022). The NIAS has also been used to examine the potential comorbidity of ARFID in individuals with gastrointestinal disorders, including gastroparesis, functional dyspepsia, achalasia, celiac disease, eosinophilic esophagitis, and inflammatory bowel disease (Burton Murray et al, 2020;Fink et al, 2022;Kaul et al, 2024;Robelin et al, 2021;Yelencich et al, 2022). However, several smaller clinical studies have now shown that the NIAS does not seem to differentiate well between ARFID and eating disorders driven by shape/weight concerns, because individuals with other eating disorders also have elevated scores on the NIAS (Billman Miller et al, 2024;Burton Murray et al, 2021).…”

“…A large number of translations and adaptations of the NIAS have been made (e.g., Billman Miller et al, 2024; Fekih-Romdhane et al, 2023; He et al, 2021; Medina-Tepal et al, 2023; Van Ouytsel et al, 2024; Ziolkowska et al, 2022), including development of a parent-report version (Ziolkowska et al, 2022). The NIAS has also been used to examine the potential comorbidity of ARFID in individuals with gastrointestinal disorders, including gastroparesis, functional dyspepsia, achalasia, celiac disease, eosinophilic esophagitis, and inflammatory bowel disease (Burton Murray et al, 2020; Fink et al, 2022; Kaul et al, 2024; Robelin et al, 2021; Yelencich et al, 2022).…”