Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study

Background: Studies suggest that there is an association between eating disorders and pelvic floor dysfunction (PFD), although the contribution of PFD toward symptomatology and interventions to improve these symptoms in the eating disorder population is poorly understood. This study seeks to describ...

Full description

Saved in:
Bibliographic Details
Main Authors: Monica Williams, Dan Blalock, Marina Foster, Philip S. Mehler, Dennis Gibson
Format: Article
Language:English
Published: IMR Press 2024-05-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/51/5/10.31083/j.ceog5105116
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850247820628459520
author Monica Williams
Dan Blalock
Marina Foster
Philip S. Mehler
Dennis Gibson
author_facet Monica Williams
Dan Blalock
Marina Foster
Philip S. Mehler
Dennis Gibson
author_sort Monica Williams
collection DOAJ
description Background: Studies suggest that there is an association between eating disorders and pelvic floor dysfunction (PFD), although the contribution of PFD toward symptomatology and interventions to improve these symptoms in the eating disorder population is poorly understood. This study seeks to describe common symptoms of PFD in an eating disorder cohort, as well as the effect of interventions on pelvic floor symptomatology. Methods: In this retrospective case-control study, 193 patients who completed the Pelvic Floor Distress Inventory (PFDI-20) upon admission and discharge were included in the study. There were 84 subjects in the control group and 109 in the intervention group, with assignment based on the patient’s willingness to participate in additional interventions for PFD. Those subjects in the intervention group received one of several interventions aimed at improving functioning of the pelvic floor muscles (education, bladder retraining/pelvic floor stretches, internal assessment of the pelvic floor muscles with intervention aimed at improving coordination of these muscles, and biofeedback). Results: Participants at admission reported a mean pelvic organ prolapse distress inventory (POPDI-6) score of 24.44, a mean colorectal-anal distress inventory (CRAD-8) score of 31.28, and a mean urinary distress inventory (UDI-6) score of 23.03, for a total PFDI-20 score of 78.75. The control group saw improvement in the total PFDI-20 score as well as each of the subscales; however, bladder training and incorporation of pelvic floor stretches resulted in improvement above that seen in the control group for each of the subscales, biofeedback resulted in improvement above that seen solely in the control group in the POPDI-6 score, and internal assessment of the pelvic floor muscles with active intervention resulted in improvement in the UDI-6 score above that seen solely in the control group. Patients with anorexia nervosa binge-eating/purging subtype reported higher PFDI symptoms than patients with the restricting subtype of anorexia nervosa, as reflected by higher scores on the POPDI-6 and CRAD-8 subscales. Conclusions: Patients with eating disorders report an increased level of pelvic floor symptomatology. Studied interventions had a positive effect in reducing these symptoms. Future studies are warranted to better describe the etiology of the PFD in those with eating disorders and how PFD contributes to eating disorder behaviors and gastrointestinal symptoms.
format Article
id doaj-art-24d75ae0a2d2418ca12bff2bb042dbfc
institution OA Journals
issn 0390-6663
language English
publishDate 2024-05-01
publisher IMR Press
record_format Article
series Clinical and Experimental Obstetrics & Gynecology
spelling doaj-art-24d75ae0a2d2418ca12bff2bb042dbfc2025-08-20T01:58:51ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-05-0151511610.31083/j.ceog5105116S0390-6663(24)02350-9Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort StudyMonica Williams0Dan Blalock1Marina Foster2Philip S. Mehler3Dennis Gibson4ACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, CO 80204, USACenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC 27705, USAACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, CO 80204, USAACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, CO 80204, USAACUTE Center for Eating Disorders and Severe Malnutrition at Denver Health, Denver, CO 80204, USABackground: Studies suggest that there is an association between eating disorders and pelvic floor dysfunction (PFD), although the contribution of PFD toward symptomatology and interventions to improve these symptoms in the eating disorder population is poorly understood. This study seeks to describe common symptoms of PFD in an eating disorder cohort, as well as the effect of interventions on pelvic floor symptomatology. Methods: In this retrospective case-control study, 193 patients who completed the Pelvic Floor Distress Inventory (PFDI-20) upon admission and discharge were included in the study. There were 84 subjects in the control group and 109 in the intervention group, with assignment based on the patient’s willingness to participate in additional interventions for PFD. Those subjects in the intervention group received one of several interventions aimed at improving functioning of the pelvic floor muscles (education, bladder retraining/pelvic floor stretches, internal assessment of the pelvic floor muscles with intervention aimed at improving coordination of these muscles, and biofeedback). Results: Participants at admission reported a mean pelvic organ prolapse distress inventory (POPDI-6) score of 24.44, a mean colorectal-anal distress inventory (CRAD-8) score of 31.28, and a mean urinary distress inventory (UDI-6) score of 23.03, for a total PFDI-20 score of 78.75. The control group saw improvement in the total PFDI-20 score as well as each of the subscales; however, bladder training and incorporation of pelvic floor stretches resulted in improvement above that seen in the control group for each of the subscales, biofeedback resulted in improvement above that seen solely in the control group in the POPDI-6 score, and internal assessment of the pelvic floor muscles with active intervention resulted in improvement in the UDI-6 score above that seen solely in the control group. Patients with anorexia nervosa binge-eating/purging subtype reported higher PFDI symptoms than patients with the restricting subtype of anorexia nervosa, as reflected by higher scores on the POPDI-6 and CRAD-8 subscales. Conclusions: Patients with eating disorders report an increased level of pelvic floor symptomatology. Studied interventions had a positive effect in reducing these symptoms. Future studies are warranted to better describe the etiology of the PFD in those with eating disorders and how PFD contributes to eating disorder behaviors and gastrointestinal symptoms.https://www.imrpress.com/journal/CEOG/51/5/10.31083/j.ceog5105116eating disordersanorexia nervosapelvic floor dysfunctionpelvic floor interventionspurging behaviors
spellingShingle Monica Williams
Dan Blalock
Marina Foster
Philip S. Mehler
Dennis Gibson
Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study
Clinical and Experimental Obstetrics & Gynecology
eating disorders
anorexia nervosa
pelvic floor dysfunction
pelvic floor interventions
purging behaviors
title Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study
title_full Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study
title_fullStr Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study
title_full_unstemmed Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study
title_short Pelvic Floor Dysfunction in People with Eating Disorders and the Acute Effect of Different Interventions – A Retrospective Cohort Study
title_sort pelvic floor dysfunction in people with eating disorders and the acute effect of different interventions a retrospective cohort study
topic eating disorders
anorexia nervosa
pelvic floor dysfunction
pelvic floor interventions
purging behaviors
url https://www.imrpress.com/journal/CEOG/51/5/10.31083/j.ceog5105116
work_keys_str_mv AT monicawilliams pelvicfloordysfunctioninpeoplewitheatingdisordersandtheacuteeffectofdifferentinterventionsaretrospectivecohortstudy
AT danblalock pelvicfloordysfunctioninpeoplewitheatingdisordersandtheacuteeffectofdifferentinterventionsaretrospectivecohortstudy
AT marinafoster pelvicfloordysfunctioninpeoplewitheatingdisordersandtheacuteeffectofdifferentinterventionsaretrospectivecohortstudy
AT philipsmehler pelvicfloordysfunctioninpeoplewitheatingdisordersandtheacuteeffectofdifferentinterventionsaretrospectivecohortstudy
AT dennisgibson pelvicfloordysfunctioninpeoplewitheatingdisordersandtheacuteeffectofdifferentinterventionsaretrospectivecohortstudy