The Prevalence and Burden of Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms in Adults with Disorders of Gut-Brain Interaction: A Population-Based Study.

Background & Aims: Individuals with disorders of gut-brain interaction (DGBI) may experience avoidant/restrictive food intake disorder (ARFID) symptoms. However, extant findings have been limited to specialist neurogastroenterology clinics. We assessed the association between DGBI and ARFID within the adult general population.

A Randomized Waitlist-Controlled Trial of a Positive Psychology Intervention for Irritable Bowel Syndrome: The WISH Proof-of-Concept Trial.

Background: Though greater positive psychological well-being (PPWB) is associated with both improved physical and mental health in irritable bowel syndrome (IBS), it has not yet been explored as a primary target of brain-gut behavior therapies (BGBTs). Accordingly, we developed a novel, 9-week, phone-delivered BGBT to cultivate PPWB in IBS, and examined its feasibility, acceptability, and preliminary effects in a randomized waitlist-controlled proof-of-concept trial.

Methods: Twenty-two adults with IBS meeting Rome IV criteria were randomized, stratified by gender and IBS subtype, to the intervention (n = 12) or waitlist-control (WLC; n = 10) groups.

Pharmacologic neuromodulation for bloating.

Background: Though bloating is a common and highly distressing symptom among patients with disorders of gut-brain interaction (DGBI), few targeted treatment options exist. In this study, we examined the use and efficacy of pharmacologic neuromodulators to treat bloating specifically.

Methods: In a retrospective study of consecutively referred patients with a DGBI ( = 77; ages 18-74, 87% female) to a tertiary neurogastroenterology clinic who were prescribed a neuromodulator for a primary complaint of bloating in 2016-2022, the degree of patient-reported bloating response (0-100%) to the maximum dose of a prescribed neuromodulator was examined using multivariable logistic regression, adjusted for key covariates.

Avoidant or Restrictive Food Intake Disorder Symptoms in Adults With Systemic Sclerosis: A Nationwide Study in Spain.

Objective: Patients with systemic sclerosis (SSc) may restrict food intake to manage their symptoms (particularly gastrointestinal [GI]). Whether some patients may develop nutritional and/or quality-of-life impairments indicative of an eating disorder, avoidant or restrictive food intake disorder (ARFID), is unknown. We aimed to (1) identify the prevalence and characteristics of ARFID symptoms in patients with SSc and (2) explore the relationship among ARFID symptoms, GI symptom burden, and health-related quality of life.

Characterization of Patients With Symptoms of Gastroparesis Having Frequent Emergency Department Visits and Hospitalizations.

Background & Aims: Patients with gastroparesis (Gp) can be high users of the medical system. In this study, we characterized patients with Gp symptoms who had frequent emergency department (ED) visits and hospitalizations.

Methods: Patients with symptoms of Gp underwent history and physical examination, gastric emptying scintigraphy (GES), and questionnaires capturing number of ED visits and hospitalizations over the prior year, GI symptoms (Patient Assessment of Upper GI Symptoms [PAGI-SYM]), anxiety and depression [Hospital Anxiety and Depression Scale (HADS)], somatization [Patient Health Questionnaire (PHQ-15)], and quality of life (SF-36v2 and Patient Assessment of Upper GastroIntestinal Disorders-Quality of Life [PAGI-QOL]).

Avoidant/Restrictive Food Intake Disorder Symptoms are Common and Impairing in Adults With Specific Phobia of Vomiting: An Exploratory Study in an Understudied Population.

Patients with specific phobia of vomiting (SPOV) often avoid foods or restrict eating aiming to prevent vomiting. However, the prevalence and correlates of avoidant/restrictive eating characteristic of avoidant/restrictive food intake disorder (ARFID) in individuals with SPOV is unknown. We aimed to examine the frequency, correlates, predictors, and detection of ARFID secondary to SPOV in adults.

A Multicenter Study to Assess Avoidant/Restrictive Food Intake Disorder in Patients with Inflammatory Bowel Disease.

Background And Aims: Disordered eating is frequently reported in patients with inflammatory bowel disease (IBD). We aimed to describe the prevalence of avoidant restrictive food intake disorder (ARFID) in patients with IBD and to identify predictors of ARFID.

Methods: Patients with IBD at 2 academic medical centers completed questionnaires including the ARFID subscale of the Pica, ARFID, and Rumination Disorder Questionnaire (PARDI-AR-Q), disease characteristics, and psychosocial variables.

Age, race and ethnicity, and sex of participants in clinical trials related to obesity.

Objective: Federal policies mandate the inclusion of historically marginalized groups in clinical trials and sociodemographic reporting on ClinicalTrials.gov. This study used ClinicalTrials.

Patterns of Symptom Change in Behaviors and Cognitions During 10-Session Cognitive Behavioral Therapy (CBT-T) for Non-Underweight Eating Disorders.

Objective: Little is known about the timing of behavioral versus cognitive change in 10-session cognitive-behavioral therapy for non-underweight eating disorders (CBT-T). We aimed to: (a) evaluate the magnitude of behavioral and cognitive symptom reduction across treatment; and (b) investigate the relation between early behavioral change and subsequent cognitive change. We hypothesized: (a) large and significant reductions in behavioral and cognitive symptoms from pre- to mid-treatment and from pre- to post-treatment; and (b) that early behavioral change would predict subsequent cognitive change over the course of treatment.

Associations between the Anxiety Sensitivity Index-3 subscales and eating pathology.

Objective: While prior research has found links between anxiety sensitivity (AS) and eating disorder (ED) symptoms, there has been limited research exploring how specific aspects of AS are related to specific dimensions of eating pathology. To inform candidate targets of specific aspects of AS in future interventions, the current study identified associations between AS and ED constructs in a sample of individuals with elevated eating pathology.

Method:  = 382 undergraduate students (89.

Psychedelic-assisted Therapy as a Promising Treatment for Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) is prevalent and can be disabling. Many patients remain symptomatic despite behavioral and medical therapies. Psychedelic-assisted therapy (PAT), in which serotonergic agents like psilocybin are administered in a psychotherapeutic context, has shown promise for refractory psychiatric disorders, including major depressive disorder and post-traumatic stress disorder.

Neural Response to Food Cues in Avoidant/Restrictive Food Intake Disorder.

Importance: The neurobiology of avoidant/restrictive food intake disorder (ARFID) is poorly understood.

Objective: To evaluate whether individuals with ARFID exhibit disruptions in fear, appetite, and disgust brain regions compared with healthy control (HC) participants when shown images of food and objects.

Design, Setting, And Participants: In this case-control study conducted from July 2016 to January 2021, children, adolescents, and young adults completed structured interviews and a validated functional magnetic resonance imaging (fMRI) food cue paradigm.

Review Article: Rome Foundation Working Team Report: Consensus Statement on the Design and Conduct of Behavioural Clinical Trials for Disorders of Gut-Brain Interaction.

Background: Brain-gut behaviour therapies (BGBT) have gained widespread acceptance as therapeutic modalities for the management of disorders of gut-brain interaction (DGBI). However, existing treatment evaluation methods in the medical field fail to capture the specific elements of scientific rigour unique to behavioural trial evaluation.

Aims: To offer the first consensus on the development and testing of BGBT in DGBI.

Bilingual Perspectives of Functional Dyspepsia Management in People From Underserved Areas.

Introduction: Disorders of gut-brain interaction, such as functional dyspepsia (FD), are prevalent and challenging conditions. In other gastrointestinal (GI) disorders, individuals from underserved areas (UAs) have difficulty accessing care. Little is known about UA FD patient perspectives of their care, especially in those with limited English proficiency.

Gut-derived appetite regulating hormones across the anorexia nervosa spectrum.

Background: Appetite-regulating hormones are implicated in anorexia nervosa (AN) pathophysiology, however, data are limited for appetite-regulating hormones across the AN weight spectrum. We aimed to investigate fasting and post-prandial concentrations of appetite-regulating hormones - peptide YY (PYY), cholecystokinin (CCK), and ghrelin - among adolescent and young adult females across the AN weight spectrum, specifically those with AN and Atypical AN, and healthy controls (HC).

Methods: Participants (N = 95; ages 11-22 years) included 33 with AN, 25 with Atypical AN, and 37 HC.

Predictors of Outcome in Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder.

Objective: Cognitive-behavioral therapy for avoidant/restrictive food intake disorder (ARFID; CBT-AR) shows promise in improving clinical outcomes in children/adolescents and adults. We aimed to identify predictors of outcomes in CBT-AR. We hypothesized that younger age, non-underweight status, and presence of the fear of aversive consequences profile of ARFID would predict greater likelihood of remission post-treatment, and that presence of the lack of interest in eating/food and sensory sensitivity profiles would predict greater likelihood of persistence post-treatment.

Dietary management of irritable bowel syndrome: considerations, challenges, and solutions.

Diet is a cornerstone in the management of irritable bowel syndrome (IBS). There is evidence of efficacy across the spectrum of dietary management strategies, including some supplements (eg, specific fibres), foods, and whole diets (eg, a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols [known as the low-FODMAP diet]). Whole-diet interventions, in particular those that restrict intake, can be challenging to deliver effectively and safely.

Difficulties in Emotion Regulation in Avoidant/Restrictive Food Intake Disorder.

Objective: Despite substantial research indicating difficulties with emotion regulation across eating disorder presentations, emotion regulation has yet to be studied in adults with avoidant/restrictive food intake disorder (ARFID). We hypothesized that (1) those with ARFID would report greater overall emotion regulation difficulties than nonclinical participants, and (2) those with ARFID would not differ from those with other eating disorders on the level of emotion regulation difficulty.

Methods: One hundred and thirty-seven adults (age 18-30) from an outpatient clinic with ARFID (n = 27), with other primarily restrictive eating disorders (e.

Transitions of care for adolescents with disorders of gut-brain interaction.

Objectives: Little is known about the experience of adolescents and young adults (AYA) with disorders of gut-brain interaction (DGBI) who transition from pediatric to adult gastroenterology care. In this two-part study, we used quantitative and qualitative methods to: (1) assess incidence of optimal versus suboptimal transitions of care for AYA with DGBI, (2) characterize health and quality of life effects of the transition, and (3) identify barriers and facilitators for optimal transition of care.

Methods: In Part 1, we conducted a retrospective review of AYA referrals to our adult neurogastroenterology clinic who had transitioned from pediatric gastroenterology care (N = 109, 17-23 years, 72% female).

Maladaptive weight control and eating behaviours in female adolescents/young adults are associated with increased risk of irritable bowel syndrome in adulthood: Results from the Growing Up Today Study (GUTS).

Background: Irritable bowel syndrome (IBS) is common among individuals with eating disorders. The relationship between these conditions is likely bidirectional. However, data on the risk of IBS among those with prior eating disorders is largely limited to cross-sectional studies.

Low Prevalence of Reporting of Participant Race and Ethnicity in Gastroenterology Research Publications.

Introduction: Empirical information on the evolution of reporting race and ethnicity information in gastroenterology research is lacking. To facilitate understanding of where improvements are needed to increase diversity, equity, and inclusion in gastroenterology research, we aimed to evaluate reporting and representation by race and ethnicity in studies published in flagship US-based gastroenterology journals over 20 years.

Methods: We manually reviewed reporting and representation by race and ethnicity in all original research articles published in the American Journal of Gastroenterology and Gastroenterology in 2000, 2010, and 2020.

Pain is a cardinal symptom cutting across Rome IV anatomical categories in disorders of gut-brain interaction: A network-based approach.

Introduction: Disorders of gut-brain interaction (DGBI) are symptom-based disorders categorized by anatomic location but have high overlap and heterogeneity. Viewing DGBI symptoms on a spectrum (i.e.

Pediatric to adult transition care in neurogastroenterology and motility: A position paper from the American Neurogastroenterology and Motility Society and European Society of Neurogastroenterology and Motility.

Transition services-programs that support adolescents and young adults (AYAs) as they move from a child-centered to a more autonomous, adult-orientated healthcare system-have been associated with improved short- and long-term healthcare outcomes. Unfortunately, there is a paucity of evidence exploring transition services within the neurogastroenterology and motility (NGM) field. The overall aim of this article, endorsed by the American Neurogastroenterology and Motility Society and European Society of Neurogastroenterology and Motility, is to promote a discussion about the role of transition services for patients with NGM disorders.

Trajectory of ghrelin and PYY around a test meal in males and females with avoidant/restrictive food intake disorder versus healthy controls.

Disruptions in appetite-regulating hormones may contribute to the development and/or maintenance of avoidant/restrictive food intake disorder (ARFID). No study has previously assessed fasting levels of orexigenic ghrelin or anorexigenic peptide YY (PYY), nor their trajectory in response to food intake among youth with ARFID across the weight spectrum. We measured fasting and postprandial (30, 60, 120 minutes post-meal) levels of ghrelin and PYY among 127 males and females with full and subthreshold ARFID (n = 95) and healthy controls (HC; n = 32).