Primary care physicians and gastroenterologists who are treating patients with irritable bowel syndrome (IBS) should screen them for eating disorders before prescribing new diets, according to an expert panel of the American Gastroenterological Association (AGA).
"We're starting to identify disordered eating behaviors in patients with IBS, and it could affect their nutritional status," Lin Chang, vice-chief of digestive health at the University of California, Los Angeles, told Medscape Medical News.
Rather than new dietary restrictions, these patients should be referred to a registered dietitian nutritionist and a mental health provider, said Chang, co-author of a new clinical practice update on the role of diet in IBS published online in Gastroenterology.
"If you feel that somebody does have disordered eating, then you wouldn't put them on a restrictive diet or an elimination diet because they probably already have restricted a lot of foods," she said.
In addition to anorexia nervosa and bulimia nervosa, a particular consideration in patients with IBS is avoidant/restrictive food intake disorder (ARFID), in which patients avoid selected foods to the point of malnutrition or unhealthy weight loss.
The update provides a set of eight questions that clinicians can use to screen their patients for disordered eating, including whether the patients have already changed their own diet, what emotions they feel at mealtime, and how much time they spend thinking about food and planning meals.
