Eating disorders are common with chronic constipation

  • Murray HB & al.
  • Clin Gastroenterol Hepatol
  • 07.01.2020

  • von Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • Almost 1 in 4 patients with chronic constipation (CC) screened positive for eating disorders (EDs) in this study. 

Why this matters

  • Among patients with disorders of gut-brain interaction, 1 in 4 has an ED.
  • CC treatment often involves dietary modification, which could be detrimental with an undiagnosed ED.
  • The authors say that this study is the first to assess ED prevalence among patients with CC seen in a gastroenterology practice.
  • Patients with CC, especially with bloating and abdominal pain, may benefit from screening for EDs.

Key results

  • 19.0% had evidence of ED on Eating Attitudes Test (EAT-26).
  • Those with ED vs without had (ORs; 95% CIs):
    • Higher general anxiety: 1.20 (1.05-1.38; P=.009).
    • Higher gastroenterology-specific anxiety: 1.06 (1.03-1.09; P<.001>
    • More severe constipation symptoms per Patient Assessment of Constipation-Symptoms (PAC-SYM) scores: 25.6 vs 21.0 (P=.001).
    • Abdominal symptoms (as opposed to rectal or stool symptoms) accounted for difference in constipation symptoms. 
  • Gastrointestinal-specific anxiety appeared to mediate the CC-ED.

Study design

  • Cross-sectional study of patients with CC referred to gastroenterology (n=279).
  • Outcomes: measures of EDs, CC, anxiety, anal pressure, colonic transit.
  • Funding: American Gastroenterological Association grant support to 1 author.

Limitations

  • EAT-26 has not been validated in gastroenterology populations.