Food sensitivities are extremely common in individuals with IBS – the great majority of individuals with the diagnosis report sensitivities to multiple foods. As a result, it is understandably common for IBS patients to try to control their symptoms by restricting or adjusting their diet to avoid triggering symptoms with food. Some individuals furthermore avoid eating for long periods when they are especially concerned about disruptive symptoms acting up, like during the workday, at social activities, or when traveling. The frequent practice of restricting or limiting eating to manage IBS has raised concerns among some clinicians that this may lead to eating disorders, especially among teenagers, who are particularly vulnerable to developing such problems.
Dr. Miranda van Tilburg on our research team at UNC-Chapel Hill was the principal investigator on a study on this topic which she presented yesterday, May 19 2012, at Digestive Disease Week in San Diego. The study examined eating-associated symptoms and the effects on eating behavior specifically in IBS patients in the adolescent age range. Forty-eight individuals with IBS and 51 healthy comparison individuals, ranging in age from 15-21, participated in the study (73.5% were females). All participants completed three separate 24-hour dietary recall telephone interviews as well as questionnaires about eating and symptoms. Eating-associated symptoms were reported by 91.7% of the IBS individuals and 28% of healthy comparison subjects . In the IBS group, symptoms associated with eating were most common for specific foods, (95.1%), fatty foods (81.8%), dairy products (79.5%) and for large meals (57.8%). Ten percent of the IBS patients reported getting symptoms from everything they ate. Practically all of the IBS patients with eating-associated symptoms reported trying to stay away from the offending foods. Many also said they skipped eating even when hungry because of the symptoms eating triggered, and 13.6% tried to control the eating-associated symptoms by vomiting after eating. However, the patients did not show evidence of eating disorders on the Eating Attitude Test, and were no different from healthy controls in their Body Mass Index, caloric intake or consumption of fats, carbohydrates and proteins.
In short, the good news from this study are that in spite of symptoms related to eating being a very common and troublesome aspect of IBS for many young people with the disorder, and it clearly affects their eating behavior significantly, there are no indications that eating-related symptoms lead to diet deficiencies or eating disorders.
Dr. van Tilburg gave me a brief summary of the findings and implications on video outside the conference hall yesterday. Take a look:
Poster Presentation: “Diet and Eating Associated Symptoms in Adolescents With IBS”. Miranda A. van Tilburg1, Megan M. Squires1, Nannette Blois-Martin1, Nancy Zucker2, Cynthia Bulik3, Denesh Chitkara1. 1Department of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC; 2Duke University Medical Center, Durham, NC; 3Eating Disorders program, University of North Carolina, Chapel Hill, NC.