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