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Gastrointestinal complaints in young women of low to normal weight may indicate possible eating disorders

Individuals with eating disorders (EDs), such as anorexia nervosa or bulimia nervosa, typically have numerous gastrointestinal (GI) complaints. Their irregular eating behaviors, such as binging, vomiting, and laxative/diuretic abuse, wreak havoc on the entire digestive tract. A new study found that young men and women (average age of 26 to 27) hospitalized for EDs were 3 times more likely to seek health care for GI problems during their illness than age-matched individuals without an ED (controls). Patients with bulimia nervosa were 2.5 times more likely than controls to seek healthcare for their GI complaints before seeking treatment for eating disorder.

Over 90 percent of the individuals studied were women. Thus, gastroenterologists and primary care physicians should screen young women of low to normal weight with GI complaints for possible EDs. They can use a simple questionnaire that addresses issues such as body image, weight loss, and vomiting. Screening may allow earlier diagnosis and treatment of EDs, which usually leads to better outcomes.

Researchers interviewed 63 patients hospitalized for ED treatment over a 1-year period as well as 47 age-matched medical students without EDs to determine when in the disease course ED patients visited primary care doctors or gastroenterologists for GI complaints. Receipt of diagnostic procedures was similar among study and control patients who sought GI care. However, patients with EDs were significantly more likely to be prescribed medication for the GI tract (primarily acid-suppressing agents) than were controls. ED patients suffered gastroesophageal reflux symptoms at significantly higher rates than did controls (4.6 vs. 0.3 reflux symptoms per week). Rates of irritable bowel syndrome were similar, but the number of patients seeking GI care in both groups was small.

The study was supported in part by the Agency for Healthcare Research and Quality (HS13852).

See "Gastrointestinal complaints in patients with eating disorders," by Nathaniel S. Winstead, M.D., M.S., and Susan G. Willard, L.C.S.W., in the September 2006 Journal of Clinical Gastroenterology 40, pp. 678-682.

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