Mo1611 – Symptoms of Avoidant/Restrictive Food Intake Disorder are Frequent in Patients Presenting to Gastroenterologists for Symptoms of Gastroparesis

Murray, Helen Burton; Jehangir, Asad; Silvernale, Casey J.; Kuo, Braden; Parkman, Henry P.

doi:10.1016/s0016-5085(19)38955-3

Cited by 20 publications

(46 citation statements)

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“…Eleven of the 17 studies examined disordered eating in patients with disorders of gut-brain interaction (DGBI), 11,16,17,[20][21][22][23][24][25][26][27] with five comparing DGBI with organic gastrointestinal disorders, 16,17,[24][25][26] and three comparing DGBI with healthy controls. 11,16,26 Five of the 17 studies examined disordered eating in organic gastrointestinal disorders alone.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review

Peters

Basnayake

Hebbard

et al. 2021

Neurogastroenterology Motil

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Background Patients with gastrointestinal disorders are prone to heightened awareness of dietary intake. When diet‐related thoughts or behaviors are excessive, they may lead to psychological distress, nutritional compromise, and impair medical treatment. Identification of disordered eating behavior and eating disorders is crucial for effective management, but data on their prevalence within this population remain scarce. We conducted a systematic review of the prevalence of disordered eating behavior and eating disorders in adults with gastrointestinal disorders. Methods MEDLINE, PubMed, and PsycInfo databases were searched up to June 2021. Studies examining disordered eating in adult patients with a primary gastrointestinal diagnosis were included. Key Results A total of 17 studies met the inclusion criteria for the review. The range of gastrointestinal disorders examined included disorders of gut‐brain interaction (DGBI), coeliac disease, and inflammatory bowel disease (IBD). The methods for examining disordered eating were highly variable. The prevalence of disordered eating ranged from 13–55%. The prevalence was higher in patients with disorders of gut‐brain interaction (DGBI) than in those with organic gastrointestinal disorders. Factors associated with disordered eating included female sex, younger age, gastrointestinal symptom severity, anxiety and depression, and lower quality of life. Conclusions & Inferences Disordered eating is highly prevalent in adult patients with gastrointestinal illness, particularly those with DGBI. Understanding whether a patient's primary underlying diagnosis is that of an eating disorder or gastroenterological disorder remains a challenge for clinicians. There is an unmet need to identify at‐risk patients so that psychological intervention can be included in the therapeutic strategy.

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Section: Methodsmentioning

confidence: 99%

Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review

Peters

Basnayake

Hebbard

et al. 2021

Neurogastroenterology Motil

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“…I ndividuals with gastrointestinal functional/motility disorders such as disorders of gut-brain interaction (DGBI) disorders of gut-brain interaction (1) are likely to avoid or restrict food intake in attempt to manage or prevent gastrointestinal symptoms (2). Recent studies show 13-40% (3)(4)(5)(6) of adults with gastrointestinal functional/motility disorders can have avoidant/restrictive eating that…”

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confidence: 99%

Prevalence and Characteristics of Avoidant/Restrictive Food Intake Disorder in Pediatric Neurogastroenterology Patients

Murray

Rao

Baker

et al. 2021

J. pediatr. gastroenterol. nutr.

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Recent reports document avoidant/restrictive food intake disorder (ARFID) symptoms among 13–40% of adults presenting to neurogastroenterology clinics, but ARFID in pediatrics is understudied. We conducted a retrospective review of charts from 129 consecutive referrals (ages 6–18 years; 57% female) for pediatric neurogastroenterology examination, from January 2016 through December 2018. Eleven cases (8%) met the full criteria for ARFID by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition and 19 cases (15%) had clinically significant avoidant/ restrictive eating behaviors with insufficient information for a definitive ARFID diagnosis. Of patients with ARFID symptoms (n = 30), 20 (67%) cited fear of gastrointestinal symptoms as motivation for their avoidant/ restrictive eating. Compared to patients without ARFID symptoms, patients with ARFID symptoms were older (P < .001), more likely to be female (51% vs 79%, P = 0.014), and more frequently presented with eating/weight-related complaints (15% vs 33%, P = 0.026). This pilot retrospective study showed ARFID symptoms present in 23% of pediatric neurogastroenterology patients; further research is needed to understand risk and maintenance factors of ARFID in the neurogastroenterology setting.

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“…Murray et al (2019) found a higher prevalence of delayed gastric emptying in those meeting criteria for ARFID than in those not meeting criteria for ARFID but still reporting GI symptoms ( p = .005). Similarly, in a sample of 410 patients referred to a neurogastroenterology center, individuals meeting criteria for ARFID ( n = 97) reported a significantly increased number of gastric complaints compared to those without ARFID ( n = 313) ( p = .001) (Murray et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Gibson

Watters

Mehler

2021

Intl J Eating Disorders

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Objective Although multiple pathophysiologic changes develop within the gastrointestinal (GI) system in the setting of malnutrition, the etiology of the reported multitude of symptoms in those with anorexia nervosa and avoidant restrictive intake disorder, as well as their contribution toward disordered eating, remain poorly understood. This systematic review seeks to better understand how these physiologic changes of malnutrition of the esophagus, stomach, intestines, and pancreas contribute toward the reported GI symptoms, as well as better understand how celiac disease, inflammatory bowel disease, pelvic floor dysfunction, and Ehlers–Danlos syndrome contribute toward disordered eating. Methods Studies of any design exploring the pathogenesis of complications and treatment strategies were included. Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines were used to structure and complete the review. Results A total of 146 articles were used for the review. The majority of studies were observational or case reports/case series. Discussion Pathophysiologic changes of the esophagus, stomach, and intestines develop with malnutrition, although these changes do not consistently correlate with expressed GI symptoms in patients with restrictive eating disorders. Celiac disease and inflammatory bowel disease also contribute to disordered eating through the associated somatic GI complaints, while pelvic floor dysfunction and Ehlers–Danlos syndrome contribute through both somatic symptoms and functional symptoms. Indeed, functional GI symptoms remain problematic during the course of treatment, and further research is required to better understand the extent to which these symptoms are functional in nature and remit or remain as treatment ensues.

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Mo1611 – Symptoms of Avoidant/Restrictive Food Intake Disorder are Frequent in Patients Presenting to Gastroenterologists for Symptoms of Gastroparesis

Cited by 20 publications

References 0 publications

Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review

Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review

Prevalence and Characteristics of Avoidant/Restrictive Food Intake Disorder in Pediatric Neurogastroenterology Patients

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

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