Eating disorders in patients with irritable bowel syndrome

Kayar, Yusuf; Ağın, Mehmet; Dertli, Ramazan; Kurtulmuş, Ayse; Boyraz, Rabia Kevser; Onur, Nafiye Selcan; Kırpınar, İsmet

doi:10.1016/j.gastre.2020.03.011

Cited by 3 publications

(4 citation statements)

References 20 publications

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“… Disordered eating behaviors may precede IBS ED‐related malnutrition impacts electrolyte depletion influencing gastric motility and emptying 103 Refeeding therapy improves gastrointestinal symptoms 104 Bidirectional relationship via brain‐gut axis Anorexia displays different composition and diversity of microbiota compared to controls 105 Anorexia displays higher levels of methane‐producing bacteria linked to slow intestinal transit, 106 similar to differences in microbiota composition seen in patients with IBS compared to healthy controls 107 IBS leads to disordered eating IBS has higher rates of disordered eating behaviors compared to controls, for example, not eating when hungry and vomiting after eating to avoid symptoms, 108 which is correlated with symptom severity 109 Gastrointestinal symptom severity and orthorexia positively correlated 110 …”

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

“…IBS leads to disordered eating IBS has higher rates of disordered eating behaviors compared to controls, for example, not eating when hungry and vomiting after eating to avoid symptoms, 108 which is correlated with symptom severity 109 Gastrointestinal symptom severity and orthorexia positively correlated 110 …”

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

See 1 more Smart Citation

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Tuck

Sultan

Tonkovic

et al. 2022

Neurogastroenterology Motil

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There is concern that use of restrictive therapeutic diets, such as those used in disorders of the gut‐brain interaction (DGBI), may increase disordered eating. In this issue of Neurogastroenterology and Motility, Burton Murray et al. and Peters et al. both demonstrate a high prevalence of disordered eating in patients with gastrointestinal conditions, particularly those with DGBI. Given these findings, it is likely that orthorexia is common in this patient group, although this was not directly examined in these studies. Orthorexia nervosa is described as an obsessive and unsafe focus on eating foods perceived as healthy. This mini‐review therefore focuses on orthorexia by conducting a scoping review, as per the PRISMA extension for scoping reviews, aimed to assess the prevalence of orthorexia, and associations between orthorexia and restrictive eating practices. While a wide range of orthorexia prevalence has been reported (0%–97%) across the 57 studies included, no studies assessed prevalence specifically in gastrointestinal conditions. Four of eight studies describing diseases associated with specific dietary patterns suggested that participants who followed a diet for “digestive issues” or “food intolerances” were at higher orthorexia risk. These results suggest that dietary modifications may be a factor contributing to orthorexia. Additionally, we provide a commentary on the clinical implications of the findings for gastrointestinal conditions including a clinical flow chart. Clinicians should consider if a restrictive diet is appropriate for individuals with DGBI and include screening for disordered eating prior to implementation of dietary modifications. Future prospective studies should evaluate orthorexia within this patient group.

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Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Tuck

Sultan

Tonkovic

et al. 2022

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…32,56 Severe IBS symptoms are associated with higher rates of disordered eating in adolescents 56 and adults. 57 One study of 45 adults with IBS found that 71% were classified as having an actual eating disorder when measured by the SCOFF questionnaire. 58 Likewise, when specifically examining the FODMAP diet, it was found that 57% of IBS patients classified as having an eating disorder closely adhered to the "restriction" phase of the diet for 6 weeks, while 36% of those who did not have an eating disorder closely adhered.…”

Section: Psychological Risksmentioning

confidence: 99%

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

Sultan

Varney

Halmos

et al. 2022

J Neurogastroenterol Motil

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Background/AimsThe 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on dietitian delivered education. However, access to dietitians can be limited, and challenges exist when applying the diet to a wide range of cultures, such as limited FODMAP analysis of local foods. This review aims to discuss ways to optimally use the FODMAP diet in practice in a wide range of cultures, directed at gastroenterologists from a dietitian's perspective. MethodsRecent literature was analysed via search databases including Medline, CINAHL, PubMed and Scopus. ResultsThe dietetic process involves detailed assessment and follow-up through the 3 stages of the FODMAP diet (restriction, re-introduction, and long-term maintenance). Emerging evidence suggests the diet can be delivered by other health professionals such as the gastroenterologist or nurse, but training on how to do so successfully would be needed. Self-guided approaches through use of technology or specialised food delivery services may be an alternative when dietitians are not available, but efficacy data is limited. Regardless of delivery mode, nutritional and psychological risks of the diet must be mitigated. Additionally, culturally appropriate education must be provided, with accommodations necessary when the FODMAP content of local foods are unknown. ConclusionWhile the diet has shown improved irritable bowel syndrome outcomes across studies, it is important to acknowledge the essential role of dietitians in implementing, tailoring, and managing the diet to achieve the best outcome for each individual.

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“…42 However, patients with IBS appear to score significantly higher than patients with IBD and healthy controls on the Eating Attitudes Test (EAT), though less than patients diagnosed with an eating disorder, suggesting they may have notable differences in eating attitudes compared to other populations. 43,44 In patients with IBS, greater adherence to the low FODMAP diet was associated with higher likelihood of an eating disorder. 45 However, given the cross-sectional nature of this study, it is difficult to determine temporality or factors that may contribute to this relationship, such as high food-related anxiety.…”

Section: Elimination Diets Increase the Risk Of Developing A Shape/weight Eating Disordermentioning

confidence: 99%

Narrative review: Risk of eating disorders and nutritional deficiencies with dietary therapies for irritable bowel syndrome

Simons

Taft

Doerfler

et al. 2021

Neurogastroenterology Motil

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Elimination diets are growing in popularity and are increasingly utilized for gastrointestinal conditions including celiac disease, 1 eosinophilic esophagitis (EoE), 2 inflammatory bowel disease (IBD), 3 and more recently, for disorders of gut-brain interaction (DGBIs), formerly known as functional gastrointestinal disorders. 4 A large number of patients with DGBIs, including irritable bowel syndrome (IBS), change eating habits based on specific beliefs about how food impacts symptoms, especially during episodes of heightened symptoms. [5][6][7] Upward of 60% of patients with gastrointestinal disorders eat a restrictive diet. 8 The literature on the benefits of elimination diet therapies is growing. 9 However, the way diets are implemented in clinical trials is not always how they are implemented

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Eating disorders in patients with irritable bowel syndrome

Cited by 3 publications

References 20 publications

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Orthorexia nervosa is a concern in gastroenterology: A scoping review

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

Narrative review: Risk of eating disorders and nutritional deficiencies with dietary therapies for irritable bowel syndrome

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