Disorders of Gut-Brain Interaction in Eating Disorders: A Review of Management Approaches.

PURPOSE OF REVIEW: Disorders of gut-brain interaction (DGBI; formerly known as functional gastrointestinal disorders) are chronic gastrointestinal conditions with no objective biomarker. DGBI such as irritable bowel syndrome and functional dyspepsia are common in eating disorders (EDs) and may maintain ED behaviors including restriction and purging, but DGBI symptoms are not explicitly addressed in standard ED treatments. This review aims to summarize pharmacological, behavioral, and nutritional support interventions for DGBI that may be beneficial in managing DGBI symptoms in individuals with EDs. RECENT FINDINGS: DGBI symptoms are common in EDs, including shape/weight-motivated EDs (e.g., anorexia nervosa) and in avoidant/restrictive food intake disorder. Theoretical work supports bi-directional risk. While evidence-based treatments for DGBI symptoms are available, there is limited research on treatment of DGBI within the context of an ED. Neuromodulator medications, brain-gut behavioral therapies (BGBTs), and nutritional support may help manage DGBI symptoms in EDs, but currently only retrospective chart reviews and case studies support this approach.  DGBI symptoms are frequently present in patients with EDs and could be an important maintaining factor for ED symptoms but further prospective research is needed. DGBI management techniques have not been well-studied in ED populations. Future research may consider adapting interventions for DGBI in ED populations.