Recap of “Managing GI Disorders in Clients with Eating Disorders” with Beth Rosen, Non-Diet RD and Gut Expert

Did you know we offer have a continuing education series in conjunction with Winston-Salem Eating Disorders Coalition called “Best Practices in the Prevention and Treatment of Disordered Eating”?

We have one more presentation on Friday, June 18th 1-2 pm, Integrating Exposure, Response Prevention and Acceptance and Commitment Therapy in the Treatment of BingeEating Disorder
Catherine Ruscitti, PsyD, CEDS. Click here to register!

This blog was written by Debra Benfield, M.Ed., RDN/LDN, CEDRD-S, RYT, Co-President of the Winston Salem Eating Disorders Coalition

It was a delight to hear from a provider with expertise in both the field of Gut Health and Eating Disorders. We know that the prevalence of Gut Health concerns are especially high in the Eating Disorders population-and visa versa. The combination is very challenging for clients and their treatment team. This post is a general summary of Beth’s presentation.

Functional GI Disorders are a group of GI symptoms related to any combination of motility disturbances, visceral hypersensitivity, altered mucosal and immune function, gut microbiota and/or central nervous system processing.

Disorders of the Gut-Brain Interaction (DGBI) are a class of GI disorders diagnosed using the Rome IV Criteria:

• evidence-based
• diagnosed by symptoms
• “different than normal”

The cycle of connection between eating disorders and DGBI: 

• malnutrition occurring in ED leads to electrolyte imbalance and metabolic myopathy
• gastric motility, intestinal transit time, and gastric emptying are impaired
• food in the GI tract produce signals from gastric distention and create the perception of fullness
• changes can occur to the gut microbiome and provoke GI symptoms, as well as the ability to regulate hunger and fullness
• And the cycle continues

Common GI Symptoms and Conditions in those with Eating Disorders:

• Gastropesophageal Reflux Disease (GERD)
  Clients with Anorexia Nervosa (AN) experience a higher prevalence of GERD than control subjects, Self-induced vomiting results in a higher risk of esophageal dysmotility, Frequent bingeing can result in altered lower esophageal sphincter (LES) function
• Superior Mesenteric Artery Syndrome (SMA) The result of the compression of the third portion of the duodenum between the superior mesenteric artery and the vertebral column. The loss of mesenteric fat causes the compression. Symptoms include loss of appetite, abdominal pain, postprandial distention, nausea and vomiting.
• Gastroparesis - Delayed gastric emptying into the duodenum in the absence of a physical obstruction. Symptoms include postprandial fullness, early satiety, nausea, vomiting, and abdominal pain.
• Irritable Bowl Syndrome - 41-52% of those diagnosed with an ED also diagnosed with IBS.

Subtypes of IBS:

IBS with predominant constipation (IBS-C)

IBS with predominant diarrhea (IBS-D)

IBS with mixed bowel habits (IBS-M)

IBS Unclassified

NOTEWORTHY

Low-FODMAP Diet is only used in the short-term and is not intended to remove foods from the diet permanently

Highly recommended that clients utilizing the Low-FODMAP Diet work with a Registered Dietitian/Nutritionist (RDN) who specializes in ED treatment and gut health

Constipation

Possible causes:

• IBS-C: Colonic hypomotility (can be caused by laxative overuse), Pelvic Floor Dysfunction

Pelvic Floor Dysfunction

• Common and under diagnosed. Symptoms include: very infrequent bowel movements (weekly or less), straining even when stool is soft, constipation does not respond to high-fiber diet, laxatives, or medication, fiber supplements/high fiber diet may exacerbate symptoms, difficulty expelling gas or need to contort body to do so, frequent need to urinate, painful sexual intercourse
  
  

In summary, eating disorders tend to create problems with gut health and gut issues place you more at risk for developing an eating disorder. It is important to seek care from providers who specialize in eating disorders with experience and expertise in gut health. It is in your best interest to discuss Gut symptoms with your ED team and ED symptoms are important to discuss with your gut health providers. Please do not hesitate to ask for help.

Beth Rosen, RD:

Website: https://goodnessgraciousliving.com/

Instagram handle: @goodnessgraciousliving

Email: beth@goodnessgraciousliving.com