Prevalence of eating disorder risk in irritable bowel syndrome, coeliac and inflammatory bowel diseases using SCOFF

Introduction

Eating disorders (EDs) and disordered eating behaviours are common in the general population. Those with gastrointestinal (GI) disorders may be particularly at risk, as they may need dietary therapies. There are no direct comparisons of the risk of EDs in patients with coeliac disease (CeD), inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). We present the first study comparing the prevalence of ED risk and risk factors in CeD, IBD and IBS using the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire.

Methods

Patients attending GI clinics with diagnosed CeD, IBD or IBS were approached to complete the SCOFF questionnaire between 2021 and 2022 and compared with controls.

Results

In total, 501 (41.6% male, mean age 46.7 years) participants completed the questionnaire. The prevalence of those at risk of EDs in patients with IBS (18%) was higher than CeD (9.4%, p=0.01), IBD (11.5%, p=0.03) and controls (6%, p<0.05). There was no difference in the risk of EDs between patients with CeD and IBD (p=0.57) nor between CeD or IBD and controls (p=0.26 and p=0.09 respectively). Patients at risk of EDs were more likely to be a younger age (OR: 0.96, 95% CI: 0.94 to 0.98) and have psychiatric disorders (OR: 3.04, 95% CI 1.87 to 4.93, p<0.001).

Conclusion

ED risk is more common in IBS than in CeD or IBD. SCOFF can be used to quickly identify patients at risk of EDs particularly those with identified risk factors, such as younger patients with pre-existing mental health conditions. Further assessment would be needed in those identified as at risk of ED.