title: Pelvic floor dysfunction predicts abdominal bloating and distension in eating disorder patients.
abstract: OBJECTIVE
  Little is known about the symptoms of abdominal bloating and distension in women with eating disorders (EDs). This study aimed to explore the prevalence and predictors of these symptoms in patients with EDs, by examining correlations with functional gastrointestinal disorders (FGIDs) including pelvic floor symptoms and other clinical features.
  
  
  METHODS
  184 ED inpatients, 16-55 years, completed on admission to hospital the ROME II symptom questionnaire, additional questions about abdominal bloating and distension, and psychological questionnaires. Prediction of abdominal bloating and distension was modeled using logistic regression analyses with individual FGIDs, psychological variables, ED type, and clinical features as the potential predictors.
  
  
  RESULTS
  Bloating (78%) was more common than distension (58%) in each ED type. In the final multivariate models, after controlling for BMI, the number of Rome II symptoms of pelvic floor dyssynergia (i.e., having to strain to pass a stool, feeling unable to empty the rectum, and having difficulty relaxing to evacuate the stool) was a significant predictor of both abdominal distension (p < 0.001) and bloating (p < 0.005). The presence of irritable bowel syndrome (IBS, 46%) was a significant predictor of bloating (p < 0.001) but not distension.
  
  
  CONCLUSIONS
  Symptoms of pelvic floor dysfunction, but not IBS, appear to be especially important in the genesis of abdominal distension in patients with ED.
authors.affiliation: Department of Obstetrics and Gynaecology, Northside Clinic, University of Sydney, Royal North Shore Hospital, Sydney, Australia. suzanne.abraham@sydney.edu.au
authors.forename: Suzanne
authors.initials: S
authors.lastname: Abraham
authors.forename: Georgina M
authors.initials: GM
authors.lastname: Luscombe
authors.forename: John E
authors.initials: JE
authors.lastname: Kellow
mesh_terms: D000293:Adolescent; D000328:Adult; D003248:Constipation / Q000150:complications / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000150:complications*; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D059952:Pelvic Floor Disorders / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult