TOPLINE:

Avoidant/restrictive eating was more common among individuals with bowel symptoms compatible with a functional bowel disorder than among those without such symptoms, and these individuals had a more severe clinical profile, including psychological and somatic symptoms.

METHODOLOGY:

• Researchers surveyed Swedish individuals aged 18-70 years with bowel symptoms compatible with functional bowel disorders and age- and sex-matched control individuals from the general population to assess the prevalence of avoidant/restrictive eating and identify its associated factors among them.
• They included 825 participants with bowel symptoms compatible with functional bowel disorders (66.2% women) and 1806 matched control individuals without bowel symptoms (60.1% women).
• All participants were administered two questionnaires, such as the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen and the Sick, Control, One, Fat, Food questionnaire, to assess the existence of disordered eating and its severity.
• The severity of overall bowel symptoms was assessed using the Irritable Bowel Syndrome-Symptom Severity Scale, along with psychological variables and quality of life.

TAKEAWAY:

• Avoidant/restrictive eating was more prevalent among individuals with bowel symptoms than among those without (22.8% vs 18.2%; P < .001).
• Participants with bowel symptoms who had avoidant/restrictive eating had a lower BMI, more severe psychological and somatic symptoms, and met the criteria for functional bowel disorder and functional dyspepsia more frequently.
• The severity of bowel symptoms was a strong predictor of the severity of avoidant/restrictive eating.
• Individuals with bowel symptoms had a higher severity of picky eating, loss of appetite, and fear of symptoms than those without bowel symptoms (P < .001 for all), with no difference in prevalence being observed between the groups.

IN PRACTICE:

"[The study] findings emphasize the need to discuss avoidant/restrictive eating, particularly fear-driven avoidance, and perform careful considerations when recommending dietary restrictions," the authors of the study wrote.

SOURCE:

This study was led by Amanda Blomsten, MD, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. It was published online on August 20, 2025, in The American Journal of Gastroenterology.

LIMITATIONS:

The study's cross-sectional design restricted the ability to establish causality or the direction of the observed associations. Although the control individuals were from the general population, other diagnoses and disorders were not excluded. The control group was age and sex matched to the bowel symptoms group, resulting in a female-dominant sample, thereby limiting the generalisability to male individuals.

DISCLOSURES:

This study was funded by the Swedish Research Council, the ALF-agreement, Erling-Persson Foundation, and the Faculty of Medicine, University of Gothenburg. One author reported receiving consultancy and speaker fees. Three authors reported serving as consultants/advisory board members and/or speakers for various pharmaceutical companies, of whom one author also reported receiving unrestricted research grants from Genetic Analysis AS and BioGaia.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.