GASTROINTESTINAL SYMPTOMS IN BULIMIA-NERVOSA - EFFECTS OF TREATMENT

Objectives: The aim of this study was to characterize the frequency an d severity of gastrointestinal symptoms in bulimic patients and to det ermine their response to treatment of the eating disorder. Methods: Fo rty-three consecutive bulimic patients admitted to the inpatient Eatin g Disorders Unit of the Psychiatry Service were asked to fill out a ga strointestinal symptoms questionnaire, an Eating Disorders Inventory, and a Zung Depression Inventory on admission and discharge. Thirty-two age- and sex-matched healthy volunteers completed the same questionna ire. Results: In bulimic patients, the most commonly reported gastroin testinal symptoms were bloating (74.4%), flatulence (74.4%), constipat ion (62.8%), decreased appetite (51.2%), abdominal pain (48.8%), borbo rygmi (48.8%), and nausea (46.5%). The average symptom score (sum of s everity ratings) on the gastrointestinal symptoms questionnaire decrea sed from 20.6 +/- 10.8 (mean +/- SD) on admission to 13.46 +/- 10.5 (t (27) = 3.31, p < 0.01) on discharge but remained significantly higher than that of the control group (4.4 +/- 6.2, t(43) = 4.02, p < 0.001). However, the severity of reported gastrointestinal symptoms was corre lated with the severity of depression (r = 0.43, p < 0.05), and when t he possible mediating effects of depression on gastrointestinal sympto ms were controlled statistically (analysis of covariance), the effects of treatment on gastrointestinal symptoms were not statistically sign ificant. Conclusion: Gastrointestinal symptoms in bulimics are common, multiple, and often severe and they improve with treatment. However, the most important determinant of gastrointestinal symptoms appears to be depression.