Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield; School of Medicine and Population Health, The University of Sheffield, Sheffield, UK. .
Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield; School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
J Gastrointestin Liver Dis. 2024 Jun 29;33(2):177-183. doi: 10.15403/jgld-5466.
There has been a growing emphasis on dietary therapies for irritable bowel syndrome (IBS). Furthermore, there has been an evolving evidence base for the low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet, gluten-free diet (GFD), and lactose-free diet. This study examines the dietary approaches employed and the factors influencing dietetic decision-making for IBS interventions.
Participants, including registered dietitians and nutritionists, were recruited from diverse healthcare settings at the point of registration for the 4th Sheffield National Dietetic Gastroenterology Symposium, 2023. A 15-question online survey investigated the practices of dietitians and nutritionists in managing IBS patients, covering dietary approaches, decision-making factors, and patient education. The evidence base for different dietary interventions was provided and a follow-up survey assessed symposium attendees, views on current IBS dietary practices.
Out of 731 respondents, primarily registered dietitians (93%) and females (93%), 54% spent 10-50% of clinic time on IBS. Respondents noted that a GFD (34%), low lactose (32%), and traditional dietary advice (TDA) (18%) were the most frequently used dietary interventions that patients try before seeking professional advice. Delegates were asked to rank their dietary intervention preferences pre- and post-meeting (after the evidence base had been presented): TDA pre-meeting 75% versus post-meeting 87% (p=0.04), fibre modification 59% versus 6% (p<0.0001), low FODMAP 25% versus 10% (p=0.0001), low lactose 12% versus 62% (p<0.0001) and GFD 6% to 23% (p<0.0001).
TDA remains the choice of diet for dietitians. After our educational event, the use of low-lactose and gluten-free diet significantly increased. Factors influencing the decision-making process were based on patient acceptability, counselling time, supporting evidence base and dietary triggers.
人们越来越关注饮食疗法在肠易激综合征（IBS）中的应用。此外，低可发酵寡糖、双糖、单糖和多元醇（FODMAP）饮食、无麸质饮食（GFD）和无乳糖饮食的循证医学证据也在不断发展。本研究旨在调查 IBS 干预措施中采用的饮食方法和影响饮食决策的因素。
参与者包括注册营养师和营养师，他们是在 2023 年第 4 届谢菲尔德国家饮食学胃肠病学研讨会注册时从不同的医疗保健场所招募的。一项 15 个问题的在线调查研究了营养师和营养师在管理 IBS 患者方面的实践，涵盖了饮食方法、决策因素和患者教育。为不同的饮食干预措施提供了循证医学证据，并在后续调查中评估了研讨会与会者对当前 IBS 饮食实践的看法。
在 731 名应答者中，主要是注册营养师（93%）和女性（93%），54%的人将 10%-50%的诊所时间用于 IBS。应答者指出，GFD（34%）、低乳糖（32%）和传统饮食建议（TDA）（18%）是患者在寻求专业建议之前最常尝试的饮食干预措施。与会者被要求在会议前后（在提供循证医学证据后）对他们的饮食干预偏好进行排名：TDA 会议前 75%，会议后 87%（p=0.04），纤维修饰 59%，6%（p<0.0001），低 FODMAP 25%，10%（p=0.0001），低乳糖 12%，62%（p<0.0001）和 GFD 6%-23%（p<0.0001）。
TDA 仍然是营养师的首选饮食。在我们的教育活动之后，低乳糖和无麸质饮食的使用显著增加。影响决策过程的因素包括患者的接受程度、咨询时间、循证医学证据基础和饮食触发因素。
