A Clinical Practice Update for the Management of Patients With Disorders of Gut‐Brain Interaction and Altered Food Intake Behavior
Year: 2026
Type: article
Abstract: BACKGROUND: Disorders of Gut-Brain Interaction (DGBI) impact as many as one in three individuals at some stage of their lives. Clinically, patients with DGBI may present with meal-related symptoms that progressively lead to altered food intake behaviors, resulting in subsequent weight loss and nutritional deficiencies. These patients often experience psychological distress and multi-system co-morbidities. This distinct subgroup can be referred to as DGBI-induced altered food intake behavior (DGBI-AFIB) and needs to be differentiated from the eating disorder defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition: Avoidant/Restrictive Food Intake Behavior. PURPOSE: There is currently no expert consensus on the management of DGBI-AFIB. To address this gap, a multidisciplinary, multi-society expert panel employed a Delphi process to develop evidence-based management guidelines for DGBI-AFIB. The group formulated and evaluated 23 statements using the GRADE system. Experts agreed that a diagnosis of DGBI-AFIB should be considered when gastrointestinal symptoms meet the Rome criteria for DGBI, are aggravated by food intake, and subsequently result in altered (reduced) food intake, leading to a significant (unintended) reduction in body weight. To establish a positive diagnosis of DGBI-AFIB, relevant differential diagnoses need consideration, including organic causes/eating disorders. A multidisciplinary team approach is key to management. Treatment must align with established DGBI principles and consider each patient's specific challenges. Enteral or parenteral feeding should only be pursued in patients with life-threatening nutritional deficiencies after all oral nutrition approaches have failed. Future research is essential to elucidate the epidemiological characteristics and risk factors for DGBI-AFIB, thereby enhancing long-term management.
Source: Neurogastroenterology & Motility
DOI: 10.1111/nmo.70337
Authors: Ayesha Shah, Nicholas J. Talley, Simon R. Knowles, Kerith Duncanson, Natasha Koloski, Jason P. Connor, Andrew S. Day, Basil Almehdawy, Chamara Basnayake, Rebecca Burgell, Sharon Carey, Charles Cock, Charlotte Daker, Vishal Kaushik, Dan Kent, Trina Kellar, Katherine Lane, Neal Martin, Allison Malcolm, Kate Elizabeth Murphy, Gemma Sharp, Caroline Tuck, Michael Jones, Nikhil Thapar, Gerald Holtmann
Institutions: The University of Queensland, Princess Alexandra Hospital, National Health and Medical Research Council, University of Newcastle Australia, Swinburne University of Technology, University of Otago, The University of Melbourne, St Vincent's Hospital Melbourne, Monash University, The University of Sydney, Royal Prince Alfred Hospital, Flinders University, Flinders Medical Centre, North Shore Hospital, Royal Brisbane and Women's Hospital, Queensland Health, Metro North Hospital and Health Service, Royal North Shore Hospital, Macquarie University, Queensland University of Technology, Children's Health Queensland Hospital and Health Service
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,640
OpenAlex ID: W7160878987