Lenhart Adrienne, Ferch Courtney, Shaw Michael, Chey William D
Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.
Spectrum Health System, Grand Rapids, MI, USA.
J Neurogastroenterol Motil. 2018 Jul 30;24(3):437-451. doi: 10.5056/jnm17116.
BACKGROUND/AIMS: Dietary therapy is increasingly used to manage gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). We aim to gauge United States gastroenterologists' perceptions of dietary therapies for IBS. METHODS: We distributed a 22-question survey to members of the American College of Gastroenterology. The survey was developed by gastroenterologists and survey methodologists. We collected information pertaining to demographics, providers' interpretation of their patients' views on dietary therapy, and gastroenterologists' perceptions on dietary therapy, and nutritional counseling in IBS. RESULTS: One thousand five hundred and sixty-two (14%) surveys were collected. Nearly 60% of participants reported that patients commonly associate food with GI symptoms. IBS patients most commonly use a trial and error approach followed by a lactose-free and gluten-free diet, and rarely use a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet on their own. Over half of providers recommend diet therapy to > 75% of IBS patients and most commonly recommend a low FODMAP diet. Only 21% of gastroenterologists commonly refer IBS patients to registered dietitians, and only 30% use GI dietitians. Female providers were more likely than males to recommend dietary changes as the primary mode of therapy (OR, 1.43 [1.09-1.88]; = 0.009). CONCLUSIONS: Our national survey identified enthusiasm for diet treatment of IBS. While patients infrequently tried a low FODMAP diet on their own, GI providers commonly recommended this diet. Only a minority of GI providers refer their IBS patients to a registered dietitian for nutrition counseling and few refer patients to dietitians with specialized GI training. Female providers were more enthusiastic about diet therapies than males.
背景/目的:饮食疗法越来越多地用于管理肠易激综合征(IBS)患者的胃肠道(GI)症状。我们旨在评估美国胃肠病学家对IBS饮食疗法的看法。 方法:我们向美国胃肠病学会成员分发了一份包含22个问题的调查问卷。该调查问卷由胃肠病学家和调查方法学家共同编制。我们收集了有关人口统计学、提供者对患者饮食疗法观点的解读、胃肠病学家对IBS饮食疗法和营养咨询的看法等信息。 结果:共收集到1562份(14%)调查问卷。近60%的参与者报告称患者通常将食物与胃肠道症状联系起来。IBS患者最常采用试错法,其次是无乳糖和无麸质饮食,很少自行采用低可发酵寡糖、双糖、单糖和多元醇(FODMAP)饮食。超过一半的提供者向超过75%的IBS患者推荐饮食疗法,最常推荐的是低FODMAP饮食。只有21%的胃肠病学家通常会将IBS患者转介给注册营养师,只有30%的人会使用胃肠病营养师。女性提供者比男性更有可能推荐饮食改变作为主要治疗方式(OR,1.43[1.09 - 1.88];P = 0.009)。 结论:我们的全国性调查显示出对IBS饮食治疗的热情。虽然患者很少自行尝试低FODMAP饮食,但胃肠病提供者通常推荐这种饮食。只有少数胃肠病提供者将他们的IBS患者转介给注册营养师进行营养咨询,很少有提供者将患者转介给接受过专门胃肠病培训的营养师。女性提供者对饮食疗法比男性更热情。
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