(PS7-54) Gastric Symptoms in Eating Disorders

Patients with eating disorders report gastrointestinal (GI) symptoms such as pain and early fullness, nausea, bloating, and vomiting (Riedlinger et al., 2020; Sato & Fukudo, 2015) and high rates of comorbidity with functional gastrointestinal disorders (Boyd, 2005). As the experience of GI symptoms could affect the willingness to tolerate interventions to normalize eating, understanding the unique experience of physical symptoms of patients with eating disorders could guide future treatment and provide clarity with clinical course and outcomes (Wildes et al., 2021).  Additionally, understanding self-report of gastrointestinal symptoms may be useful as a diagnostic tool in eating disorders. 

The aim of this analysis was to compare self-reported gastrointestinal symptoms in eating disorder patients to healthy controls using the Gastroparesis Cardinal Symptom Index (GCSI) from a larger project of gastric rhythm. We hypothesized that individuals with eating disorders, as determined by the Eating Disorder Assessment for DSM-5, would score higher on the GCSI, on average, than healthy controls. Participants (N = 51) completed the GCSI after a 4-hour fast, prior to having their stomach rhythm recorded. The GCSI is a valid and reliable self-report measure used to measure gastrointestinal symptoms (Revicki et al., 2004) with the total score reflecting a participant’s 24-hour recall of nausea, early fullness, excessive fullness, abdominal pain, and vomiting. 

A linear regression model was run including group (eating disorder or healthy control), age, BMI, gender, ethnicity, and race (White or Non-White) and independent samples t-test for differences in GCSI score.  A significant effect of group (eating disorder versus healthy control) was found on GCSI score (p < 0.01). We did not find a significant effect of age, BMI, gender, ethnicity, or race on GCSI score. This study continues to recruit participants, and a larger sample will allow for further investigation of the effects of variables such as diagnosis on this GCSI difference.  

Understanding the physical symptoms of eating disorders can guide cognitive and behavioral treatments for eating disorders through revealing important treatment targets. Given the presence of uncomfortable bodily sensations, treatments such as Interoceptive Exposure (IE) utilize exposure-based therapy to help patients with discomfort in the re-feeding process (Hildebrandt et al., 2021). Evidence of significant GI symptoms in the ED population serves as further support for incorporating such interventions into eating disorder treatment. Furthermore, the difference in report of gastrointestinal symptoms in eating disorder patients and healthy controls may help clinicians identify individuals with eating disorders.