Prolonged constipation and diarrhea in childhood and disordered eating in adolescence

• Published in: Journal of psychosomatic research 2019-11, Vol.126, p.109797-109797, Article 109797
• Main Authors: Wiklund, Camilla A., Kuja-Halkola, Ralf, Thornton, Laura M., Hübel, Christopher, Leppä, Virpi, Bulik, Cynthia M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Child development; Childhood; Children; Confounding factors; Constipation; Constipation - complications; Diarrhea; Diarrhea - complications; Eating disorders; Feeding and Eating Disorders - physiopathology; Female; Gastrointestinal problems; Humans; Longitudinal Studies; Male; Medicin och hälsovetenskap; Regression analysis
• ISSN: 0022-3999; 1879-1360; 1879-1360
• DOI: 10.1016/j.jpsychores.2019.109797

Gastrointestinal problems are common in all eating disorders; however, the extent to which these problems predate the onset of eating disorders is not clear. We explored longitudinal associations between childhood gastrointestinal problems and adolescent disordered eating, and assessed whether observed associations are potentially causal or due to familial confounding factors. Data from a population-based Swedish twin sample were used to investigate associations between parent- and self-reported protracted constipation and diarrhea in childhood and adolescence, and later disordered eating, measured by the Eating Disorders Inventory-2 (EDI). Linear regression models were used to investigate the associations. Possible familial confounding was explored by using a within-twin pair analysis. We found that those who reported a history of constipation at age 15 scored 5.55 and 5.04 points higher, respectively, on the EDI total score at age 15 and 18, compared with those without constipation. Those reporting a history of diarrhea at age 15 scored 5.15 points higher, and the group reporting both problems scored 9.52 points higher on the EDI total score at age 15 than those reporting no problems. We observed that the association between constipation and disordered eating was attenuated in the within-twin pair analysis, but remained positive. Gastrointestinal problems in childhood and adolescence are significantly associated with disordered eating. Associations were partly due to familial confounding, but might also be consistent with a causal interpretation. Clinicians should be aware of the increased risk of disordered eating when following children and adolescents who present with gastrointestinal problems. •Childhood constipation is associated with adolescent disordered eating.•Diarrhea in childhood is associated with adolescent disordered eating.•Association are partly explained by familial factors.•Clinicians should be aware of the increased risk.