Gastrointestinal Symptoms in Bulimia Nervosa: Effects of Treatment

Tawfik N. Chami, Arnold E. Andersen, Michael D. Crowell, Marvin M. Schuster, William E. Whitehead

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Objectives: The aim of this study was to characterize the frequency and severity of gastrointestinal symptoms in bulimic patients and to determine their response to treatment of the eating disorder. Methods: Forty‐three consecutive bulimic patients admitted to the inpatient Eating Disorders Unit of the Psychiatry Service were asked to fill out a gastrointestinal 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 questionnaire. Results: In bulimic patients, the most commonly reported gastrointestinal symptoms were bloating (74.4%), flatulence (74.4%), constipation (62.8%), decreased appetite (51.2%), abdominal pain (48.8%), borborygmi (48.8%), and nausea (46.5%). The average symptom score (sum of severity ratings) on the gastrointestinal symptoms questionnaire decreased from 20.6 ± 10.8 (mean ± SD) on admission lo 13.46 ± 10.5 (t(27) = 3.31, p < 11.01) 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 correlated with the severity of depression (r = 0.43. p < 0.05), and when the possible mediating effects of depression on gastrointestinal symptoms were controlled statistically (analysis of covariance), the effects of treatment on gastrointestinal symptoms were not statistically significant. 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.

Original languageEnglish (US)
Pages (from-to)88-92
Number of pages5
JournalThe American Journal of Gastroenterology
Issue number1
StatePublished - Jan 1995

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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