Appearance and disappearance of functional gastrointestinal disorders in patients with eating disorders

Background Functional gastrointestinal disorders or 'functional gastrointestinal disorder-like' symptoms (FGIDs) occur commonly in eating disorders (ED), but it is not known if these disorders are stable over time. The aims were to evaluate the turnover of FGIDs in patients with ED, and to relate this turnover to changes in body mass index (BMI), ED behaviors, and psychological variables. Methods Patterns and repeated measures analysis of presence of individual FGIDs and regional FGID categories (esophageal, gastroduodenal, bowel, and anorectal) in ED patients (n = 73) at admission to hospital and at 12-month follow-up, using change in BMI and ED behaviors as between patient variables. Key Results Functional gastrointestinal disorders prevalence was 97% at admission and 77% at follow-up. The only individual FGIDs to decrease over time were functional heartburn (admission 53%, follow-up 23%) and functional dysphagia (21%, 7%). There was significant patient variation in the disappearance, persistence, and appearance of both individual FGIDs and FGID regional categories. Twenty-five (34%) of patients acquired at least one new FGID regional category at follow-up. There was no relationship between changes in BMI, self-induced vomiting, laxative use, binge eating, anxiety, depression, somatization, and the turnover of individual or regional FGIDs. Conclusions & Inferences Functional gastrointestinal disorders remain common after 12 months in patients with an ED. Considerable turnover of the FGIDs occurs, however, and the appearance of new FGIDs is not restricted to the original FGID regional category. There is no apparent relationship between the turnover of the FGIDs and ED behaviors, psychological variables or body weight change. These findings have implications for the clinical evaluation and management of FGIDs in ED patients.