How to execute dietary management in eating disorder patients

Nov 19, 2009

Substances that provoke gastrointestinal symptoms in patients with eating disorders (ED) can impact negatively on their nutritional rehabilitation. An Australian research group has found that ingestion of fructose-sorbitol (F-S) provoked gastrointestinal symptoms in more than half of a group of female ED patients, and symptoms were more marked in the most underweight patients. These findings indicate that F-S provocative testing could play a valuable role in the clinical management of ED patients.

Eating disorders (ED) patients display a high prevalence of gastrointestinal symptoms and functional gastrointestinal disorders such as irritable bowel syndrome. These symptoms may interfere with their nutritional management. Ingestion of fructose-sorbitol (F-S) is an established means of gastrointestinal symptom provocation in patients. Surprisingly, although ED patients are known to consume "diet" products containing fructose and sorbitol, their gastrointestinal symptom responses to F-S provocation have not been studied.

A research article published on November 14, 2009 in the World Journal of Gastroenterology describes the responses of 26 ED patients to F-S provocation. The research team, including Professors Kellow, Abraham and Hansen from the University of Sydney, Australia, monitored gastrointestinal symptoms and breath hydrogen concentration (a marker of small bowel absorption) for 3 h following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day. Responses to F-S were compared to those of 20 asymptomatic healthy females.

F-S provoked gastrointestinal symptoms in 15 ED patients but only in one healthy control. In contrast, only one ED patient displayed symptom provocation to glucose, which does not usually provoke gastrointestinal symptoms; this shows specificity of the F-S response. A greater symptom response was observed in the most underweight ED patients (BMI ≤ 17.5 kg/m2) compared to those with a BMI >17.5 kg/m2. There were no differences in psychological scores, prevalence of functional gastrointestinal disorders or breath hydrogen responses between patients with and without an F-S response.

The key findings of this study are that F-S provoked gastrointestinal symptoms in more than half of the female ED patients, a significantly greater proportion than that found in healthy individuals; the response was specific for F-S ingestion; and there was a greater symptom response in patients at lower BMI values. Consistent with this last finding, symptom provocation was more common in anorexia nervosa patients. Hence negative energy balance appears to play a role in F-S sensitivity in these patients. As and sorbitol are likely to be commonly ingested by ED patients, representing a potential source of gastrointestinal distress that would impact negatively on their nutritional management, F-S provocative testing could prove valuable in identifying those patients with symptom sensitivity to these substances.

More information: Friesen N, Hansen RD, Abraham SF, Kellow JE. Fructosesorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders. World J Gastroenterol 2009; 15(42): 5295-5299, www.wjgnet.com/1007-9327/15/5295.asp

Source: (news : web)

Explore further: Canada sending medics to West Africa to fight Ebola

add to favorites email to friend print save as pdf

Related Stories

What is the etiology of cardiac syndrome X?

Dec 01, 2008

Non-cardiac chest pain remains a widespread symptom especially in western countries with a significant economic burden. Patients with chest pain and abnormal electrocardiographic (ECG) but normal coronary angiogram (i.e. ...

Allergic disease linked to irritable bowel syndrome

Jan 30, 2008

Adults with allergy symptoms report a high incidence of Irritable Bowel Syndrome (IBS), suggesting a link between atopic disorders and IBS according to a study published this month in Annals of Allergy, Asthma & Immunology, ...

Acute gastric injury due to high-dose analgesics?

Dec 29, 2008

Analgesics, NSAIDs and acetaminophen, are commonly used for the relief of fever, headaches, and other minor aches and pains. The gastrointestinal side effects of NSAIDs are well documented and acetaminophen is accepted to ...

Recommended for you

Ebola aid dogged by coordination lags in Guinea

4 hours ago

Eight months into West Africa's Ebola outbreak, aid efforts in Guinea still suffer from poor coordination, hampering deployments of international support to help quell a virus that has killed more than 1,200 ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.