Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Int J Eat Disord. 2021 Jun;54(6):925-935. doi: 10.1002/eat.23527. Epub 2021 May 6.
Eating disorders commonly co-occur with gastrointestinal problems. This case-control study aimed to (a) document the prevalence of disorders of gut-brain interaction (DGBI) in eating disorders, (b) examine the specific impact of disordered eating behaviors on the risk of DGBI, and (c) explore the impact of current eating disorder psychopathology on DGBI.
We included 765 cases with eating disorders and 1,240 controls. DGBI were assessed via the ROME III questionnaire. Prevalences of DGBI were calculated across eating disorder diagnoses (anorexia nervosa, bulimia nervosa, and multiple eating disorders) and in controls. The association between disordered eating behaviors and DGBI was examined using logistic regression models. Lastly, we compared the total number of DGBI in individuals with high versus low current eating disorder symptoms.
A large majority (88.2-95.5%) of individuals with eating disorders reported at least one DGBI and 34.8-48.7% reported three or more DGBI. Of the DGBI categories, functional bowel disorders were the most commonly endorsed category, and of the individual DGBI, irritable bowel syndrome was the most frequently reported (43.9-58.8%). All investigated disordered eating behaviors showed a positive association with most DGBI categories. Finally, individuals reporting high current eating disorder symptoms reported higher mean number of DGBI (3.03-3.34) than those with low current symptoms (1.60-1.84).
The directionality and mechanisms underlying the nature of the relationship between gastrointestinal and eating disorder symptoms is worthy of further study and clinicians should adopt an integrated approach by attending to both gastrointestinal and eating disorder symptoms in their patients.
饮食障碍通常与胃肠道问题共同发生。本病例对照研究旨在：(a)记录肠-脑互动障碍(DGBI)在饮食障碍中的流行情况；(b)研究饮食障碍行为对 DGBI 风险的具体影响；(c)探索当前饮食障碍心理病理学对 DGBI 的影响。
我们纳入了 765 例饮食障碍患者和 1240 例对照。通过 ROME III 问卷评估 DGBI。在各种饮食障碍诊断(神经性厌食症、神经性贪食症和多种饮食障碍)和对照组中计算 DGBI 的患病率。使用逻辑回归模型检查饮食障碍行为与 DGBI 之间的关联。最后，我们比较了高、低当前饮食障碍症状个体中 DGBI 的总数。
绝大多数(88.2%-95.5%)饮食障碍患者报告至少有一种 DGBI，34.8%-48.7%报告有三种或更多种 DGBI。在 DGBI 类别中，功能性肠病是最常被报告的类别，在个体 DGBI 中，肠易激综合征是最常报告的疾病(43.9%-58.8%)。所有调查的饮食障碍行为与大多数 DGBI 类别均呈正相关。最后，报告高当前饮食障碍症状的个体报告的 DGBI 平均数量较高(3.03-3.34)，而报告低当前症状的个体报告的 DGBI 平均数量较低(1.60-1.84)。
胃肠道和饮食障碍症状之间关系的性质及其背后的方向性和机制值得进一步研究，临床医生应在关注患者胃肠道和饮食障碍症状的基础上，采用综合治疗方法。
