Functional gastrointestinal disorders in eating disorder patients: Altered distribution and predictors using ROME III compared to ROME II criteria

Table 1 Descriptive details and diagnoses of the ROME III and ROME II cohorts¹

Descriptive details	ROME III cohortn = 100	ROME II cohortn = 160
	Mean ± SD	Mean ± SD
Age (yr)	25.1 ± 7.9	24.7 ± 6.4
Current BMI kg/m2	18.5 ± 3.8	18.2 ± 3.6
Lowest BMI kg/m2	15.9 ± 2.9	15.7 ± 4.2
QOL ED score2	16.0 ± 3.5	16.3 ± 3.2
ED diagnoses	%	%
AN-R	27	26
AN-P	20	20
BN	9	18
EDNOS-R	14	11
EDNOS-P	30	25

¹No significant differences between cohorts for descriptive details or diagnoses;

²Range 0 to 24, > 7 indicative of the presence of an ED. AN-R: Anorexia nervosa-restricting; AN-P: Anorexia nervosa-purging; BN: Bulimia nervosa; EDNOS-R: Eating disorder not otherwise specified-restricting; EDNOS-P: Eating disorder not otherwise specified-purging; QOL ED: QOL related to eating disorders.

Table 2 Prevalence of functional gastrointestinal disorders categories for ROME III (with and without 6-mo requirement) and ROME II (with 3-mo requirement)

	ROME III cohort (n = 100)		ROME II cohort (n = 160)
	With 6-mo requirement	With 3-mo requirement	Present 3 mo or more
Region
A: Functional Esophageal Disorders	34%	55%	40%
B: Functional Gastroduodenal Disorders	62%	79%	16%
Without cyclic vomiting	45%	60%
C: Functional Bowel Disorders	77%	98%	88%
Without unspecified bowel disease	53%	80%
D: Functional Abdominal Pain Syndrome	3%	6%	4%
E: Functional Gallbladder and Sphincter of Oddi Disorders	0%		2%
F: Functional Anorectal Disorders1	16%	20%	35%
Total
At least one FGID	83%		94%
At least 3 FGIDs	34%		36%

¹Two ROME III functional gastrointestinal disorders (FGIDs) within the functional anorectal disorder category are for 3 mo only (and F1. Functional Fecal Incontinence not included).

Table 3 Prevalence of individual functional gastrointestinal disorders present in ROME III with and without 6-mo presence requirement and the prevalence of these in ROME II

	ROME III (n = 100)		ROME II (n = 160)
	With 6-mo requirement	With 3-mo requirement	Present 3 mo or more
A1: Functional Heartburn1	22%	26%	24%
A2: Functional Chest Pain of Presumed Esophageal Origin1	8%	17%	4%
A3: Functional Dysphagia1	6%	16%	9%
A4: Globus1	1%	2%	5%
B1: Functional Dyspepsia1	0%	57%	7%
B1a: Postprandial Distress Syndrome1	45%	72%	-
B2a: Aerophagia1	14% (a,b combined)	18% (a,b combined)	11%
B2b: Unspecified Excessive Belching1			-
B3a: Chronic idiopathic nausea1	10%	14%	-
B3c: Cyclic vomiting syndrome	17%	19%	-
B4: Rumination Syndrome in Adults1	7%	7%	2%
C1: Irritable Bowel Syndrome1	41%	57%	45%
C2: Functional Bloating1	1%	3%	30%
C3: Functional Constipation1	11%	27%	26%
C5: Unspecified Functional Bowel Disorder1	24%	18%	-
F1: Functional Fecal Incontinence (3 mo)	15%	15%	11%
F2a: Chronic Proctalgia1	5%	5%	-
F2b: Proctalgia Fugax (3 mo)	11%	11%	21%

¹FGID in ROME III and ROME II; B3b. Functional vomiting¹ is excluded for ED patients. Prevalences of individual FGID < 5 excluded from table, B1b: Epigastric pain syndrome¹; C4: Functional diarrhea¹; D: Functional abdominal pain syndrome; E: Functional gallbladder and sphincter of oddi disorders; E1: Functional gallbladder disorder; E2: Functional biliary sphincter of oddi disorder; E3: Functional pancreatic sphincter of oddi disorder; F3: Functional defecation disorders.

Table 4 Prevalence of functional gastrointestinal disorders categories for ROME III (with 6-mo requirement) by eating disorder sub-types

	ROME III cohort
	AN-R (n = 27)	AN-P (n = 20)	BN (n = 9)	EDNOS-R (n = 14)	EDNOS-P (n = 30)
A: Functional Esophageal Disorders	14.8%	35.0%	33.3%	42.9%	46.7%
B: Functional Gastroduodenal Disorders	44.4%	75.0%	88.9%	42.9%	70.0%
Without cyclic vomiting	44.4%	60.0%	44.4%	35.7%	40.0%
C: Functional Bowel Disorders	63.0%	85.0%	77.8%	85.7%	80.0%
Without unspecified bowel disease	40.7%	65.0%	55.6%	50.0%	56.7%
D: Functional Abdominal Pain Syndrome	7.4%	5.0%	0.0%	0.0%	0.0%
E: Functional Anorectal Disorders1	7.4%	10.0%	11.1%	35.7%	20.0%
Total
At least one FGID	70.4%	95.0%	88.9%	85.7%	83.3%
At least 3 FGIDs	18.5%	40.0%	33.3%	35.7%	43.3%

¹Functional fecal incontinence not included. AN-R: Anorexia nervosa-restricting; AN-P: Anorexia nervosa-purging; BN: Bulimia nervosa; EDNOS-R: Eating disorder not otherwise specified-restricting; EDNOS-P: Eating disorder not otherwise specified-purging; NB: Functional gallbladder and sphincter of oddi disorders were absent for the entire sample; FGID: Functional gastrointestinal disorders.

Table 5 Behavioural and psychological predictors of the commonly occurring ROME III functional gastrointestinal disorders among eating disorder patients

ROME III FGID	Predictors	B	Wald	υ	P	OR	95%CI
A1: Functional Heartburn	Somatisation	0.13	5.31	1	0.021	1.14	1.02	1.27
B1a: Postprandial Distress Syndrome	Starvation	0.58	6.99	1	0.008	1.79	1.16	2.76
	Exercise	-0.57	6.23	1	0.013	0.56	0.36	0.88
	Depression	0.67	4.73	1	0.030	1.07	1.01	1.14
C1: Irritable Bowel Syndrome	Laxatives	0.46	5.05	1	0.025	1.58	1.06	2.35
C5: Unspecified Functional Bowel Disorder	Somatisation	-0.19	7.21	1	0.007	0.83	0.73	0.95

The potential predictors: Age, BMI, binge eating behaviour, vomiting, depression and state and trait anxiety did not predict any common functional gastrointestinal disorders (FGIDs). There were no significant predictors of presence of three or more FGIDs.