Differential Diagnoses of Food-Related Gastrointestinal Symptoms in Patients with Anorexia Nervosa and Bulimia Nervosa: A Review of Literature

Z Psychosom Med Psychother. 2018 Mar;64(1):4-15. doi: 10.13109/zptm.2018.64.1.4.

Abstract

Objectives: The present review investigates the prevalence and medical causes of food-related gastrointestinal symptoms in eating disorder (ED) patients and recommends a diagnostic algorithm based on the current literature.

Methods: A literature search was conducted, which included publications from January 2000 until January 2017 Results: Over 90% of ED patients suffer from food-related symptoms. There is no evidence for a higher prevalence of immunological or structural gastrointestinal disorders in ED patients compared to the healthy population. Most food-related symptoms in ED patients are likely to be functional.

Conclusions: Diagnostic work-up of food-related symptoms in ED patients needs to be based on clinical history. Only if timing and quality of symptoms point towards a disorder independent from the ED is a comprehensive diagnostic work-up necessary.

Keywords: Anorexia Nervosa; Bulimia Nervosa; Eating Disorder; Food Allergy; Food Intolerance; Gastrointestinal Disorder.

Publication types

  • Review

MeSH terms

  • Anorexia Nervosa / diagnosis*
  • Anorexia Nervosa / epidemiology
  • Anorexia Nervosa / psychology
  • Bulimia Nervosa / diagnosis*
  • Bulimia Nervosa / epidemiology
  • Bulimia Nervosa / psychology
  • Celiac Disease / diagnosis
  • Celiac Disease / epidemiology
  • Celiac Disease / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Esophageal Achalasia / diagnosis
  • Esophageal Achalasia / epidemiology
  • Esophageal Achalasia / psychology
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / psychology
  • Food Intolerance / diagnosis
  • Food Intolerance / epidemiology
  • Food Intolerance / psychology
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / psychology
  • Humans
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / psychology