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Multicenter Study
. 2020 Dec;32(12):e13931.
doi: 10.1111/nmo.13931. Epub 2020 Jul 16.

Avoidant/restrictive food intake disorder symptoms are frequent in patients presenting for symptoms of gastroparesis

Helen Burton Murray  1   2   3 , Asad Jehangir  4 , Casey J Silvernale  3 , Braden Kuo  2   3 , Henry P Parkman  4
Affiliations
Multicenter Study

Avoidant/restrictive food intake disorder symptoms are frequent in patients presenting for symptoms of gastroparesis

Helen Burton Murray et al. Neurogastroenterol Motil. 2020 Dec.

Abstract

Introduction: Patients with symptoms of gastroparesis/dyspepsia often avoid foods or restrict eating for symptom management. There is growing interest in understanding risk for feeding/eating disorders (FEDs) like avoidant/restrictive food intake disorder (ARFID). Among patients presenting with gastroparesis/dyspepsia symptoms, we aimed to determine: (a) FED symptom frequency, and (b) relation of FED symptoms to gastrointestinal symptom severity and gastric retention abnormalities.

Methods: Adult patients (N = 288; 78% female) referred for gastroparesis/dyspepsia symptoms at two academic medical centers from January 2018-February 2019 completed self-report surveys for gastrointestinal symptom severity and FED symptoms. Gastric retention data were available for 210 patients, using 4-hour EggBeater gastric emptying scintigraphy (GES).

Results: Clinically significant FED symptoms were present in 158 patients (54.9%). Interestingly, 115 patients (39.9%) met conservative self-report cutoff for ARFID symptoms, with 67 (23.3%) patients having documented psychosocial/medical impairment. Of those with survey data for other FEDs (n = 239), only 28 patients (11.7%) had restrictive eating disorders (anorexia nervosa; unspecified FED). Likelihood of having FED symptoms was significantly associated with greater gastroparesis symptom severity (OR = 2.23, P < .001), but not GES. In addition, gastroparesis symptom severity was moderately and significantly associated with greater ARFID symptom severity (b = 0.45, P < .001), but neither GES nor other FED symptoms.

Discussion: In patients presenting with gastroparesis/dyspepsia symptoms, FED symptoms were frequent (55%), particularly ARFID, and were associated with greater gastrointestinal symptom severity, but not gastric retention. Gastroparesis/dyspepsia symptoms may mimic FEDs, particularly ARFID. Clinicians should be cautious about diagnosing ARFID in gastroparesis/dyspepsia patients, and screening for ARFID could assist behavioral treatment referral.

Keywords: avoidant/restrictive food intake disorder; eating disorder; feeding disorder; functional dyspepsia; gastric retention; gastroparesis.

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References

REFERENCES

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