Prevalence and Characteristics of Avoidant/Restrictive Food Intake Disorder in Adult Neurogastroenterology Patients
Prevalence and Characteristics of Avoidant/Restrictive Food Intake Disorder in Adult Neurogastroenterology Patients
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DOI：
10.1016/j.cgh.2019.10.030
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发表时间：
2020-08-01
影响因子：
12.6
通讯作者：
Kuo, Braden
中科院分区：
文献类型：
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作者：
Murray, Helen Burton;Bailey, Abbey P.;Kuo, Braden
背景与目的：避免/限制性食物摄入障碍（ARFID）是一种喂养和饮食障碍，其特征是避免或限制性饮食，主要不是出于体型或体重考虑。我们的目的是确定ARFID症状的频率，并研究其特点和相关的胃肠道symptoms.METHODS：我们进行了一项回顾性研究，从2016年1月至12月，从410个连续转诊（年龄，18-90岁; 73.0%女性）到三级保健中心进行神经胃肠病学检查的图表。结果：26例（6.3%）符合ARFID诊断标准，71例（17.3%）有明显的回避或限制性饮食行为，但缺乏足够的信息来确诊ARFID。在ARFID症状患者（n=97）中，90例患者（92.8%）将对胃肠道症状的恐惧作为他们避免或限制饮食的动机。一系列二元逻辑回归分析表明，有进食或体重相关主诉的患者出现ARFID症状的可能性显著增加（比值比[OR]，5.09; 95% CI，2.54-10.21）;伴有消化不良、恶心或呕吐（OR，3.59; 95%CI，2.04-6.32）;伴有腹痛（OR，4.72; 95% CI，1.87-11.81）;或下消化道诊断（OR，2.40; 95% CI，1.34-4.32）。在一项对接受神经胃肠病学检查的患者进行的回顾性研究中，我们发现ARFID症状最常与对胃肠道症状的恐惧有关。接受神经胃肠病学或动力学检查的患者应评估ARFID的症状，特别是当提供者考虑饮食干预时。
BACKGROUND & AIMS: Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder that is characterized by avoidant or restrictive eating not primarily motivated by body shape or weight concerns. We aimed to determine the frequency of ARFID symptoms and study its characteristics and associated gastrointestinal symptoms.METHODS: We conducted a retrospective review of charts from 410 consecutive referrals (ages, 18-90 y; 73.0% female) to a tertiary care center for neurogastroenterology examination, from January through December 2016. Blinded coders (n=4) applied Diagnostic and Statistical Manual of Mental Disorders, 5th edition, criteria for ARFID, with substantial diagnostic agreement (k=0.66).RESULTS: Twenty-six cases (6.3%) met the full criteria for ARFID and 71 cases (17.3%) had clinically significant avoidant or restrictive eating behaviors with insufficient information for a definitive diagnosis of ARFID. Of patients with ARFID symptoms (n=97), 90 patients (92.8%) cited fear of gastrointestinal symptoms as motivation for their avoidant or restrictive eating. A series of binary logistic regressions showed that the likelihood of having ARFID symptoms increased significantly in patients with eating- or weight-related complaints (odds ratio[OR], 5.09; 95% CI, 2.54-10.21); with dyspepsia, nausea, or vomiting (OR, 3.59; 95% CI, 2.04-6.32); with abdominal pain (OR, 4.72; 95% CI, 1.87-11.81); or with lower GI diagnoses (OR, 2.40; 95% CI, 1.34-4.32).CONCLUSIONS: In a retrospective study of patients undergoing neurogastroenterology examinations, we found ARFID symptoms to be related most frequently to fear of gastrointestinal symptoms. Patients undergoing neurogastroenterology or motility examinations should be evaluated for symptoms of ARFID, particularly when providers consider dietary interventions.