Inflammatory Bowel Disease (IBD), characterized by chronic inflammation of the gastrointestinal tract, affects millions worldwide and significantly disrupts patients’ quality of life. Dietary management remains a cornerstone of patient care in IBD treatment, with food avoidance behaviors commonly reported among sufferers. A study published in Clinical Nutrition ESPEN (DOI: 10.1016/j.clnesp.2019.03.018) sheds light on these patterns, uncovering concerning trends in nutritional well-being and confidence in dietary advice.
The Study on Food Avoidance in IBD Outpatients
Researchers at the Royal Brisbane and Women’s Hospital and The University of Queensland conducted a cross-sectional study to explore food avoidance behaviors among IBD outpatients and examine the relationship between these behaviors and disease factors, as well as patients’ confidence in dietary advice.
Methodology
A total of 117 IBD outpatients were included in a prospective cross-sectional study. The comprehensive approach included structured interviews, nutritional assessments, and medical record reviews to ensure accurate and thorough findings. Participants were asked about the foods they avoided and the reasons behind these decisions. Additionally, the study sought to understand patients’ previous diet advice experiences, evaluating source credibility and confidence levels.
Results
The results were telling; almost 90% of participants reported avoiding certain foods. This was markedly pronounced during active disease phases, with an average of 5.2 ± 3.6 foods or food categories being avoided, contrasting with 2.9 ± 2.5 during remission periods.
During both active disease and remission phases, the most common reasons for food avoidance included pain and cramping, increased bowel motions, and diarrhea. The internet emerged as the most trusted source for dietary advice during active disease, while during remission, gastroenterologists were regarded as the most reliable.
Concerns and Implications
A troubling revelation was the high prevalence of avoiding nutritious foods, combined with the low confidence patients had in dietetic advice. The study’s findings highlight the need for improved communication and trust between patients and healthcare professionals to provide evidence-based dietary recommendations that do not compromise nutritional quality.
Reflections and Recommendations from Experts
Abigail Marsh, lead author and dietitian at Royal Brisbane and Women’s Hospital, emphasizes the implications for patient care: “The fact that patients often turn to the internet during active disease points to a larger issue of accessibility and trust in healthcare providers. We must work diligently to bridge these gaps to ensure patients feel supported and correctly informed about their dietary choices.”
Graham Radford-Smith, a gastroenterologist and co-author of the study, concurs: “It’s essential for patients with IBD to receive holistic care that addresses their nutritional needs. This research indicates the urgent necessity to enhance the dietitian-patient relationship and tailor nutrition therapy to individual needs.”
Keywords
1. Inflammatory Bowel Disease Diet
2. IBD Food Avoidance
3. Nutritional Therapy IBD
4. Dietary Advice Inflammatory Bowel
5. IBD Dietary Management
References
1. Abigail Marsh, et al. (2019). Food avoidance in outpatients with Inflammatory Bowel Disease – Who, what and why. Clinical Nutrition ESPEN, 31, 10–16. DOI: 10.1016/j.clnesp.2019.03.018
2. Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Berto, E., Luzi, C., & Andreoli, A. (1993). Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission. The American journal of gastroenterology, 88(6), 915–922.
3. Limdi, J. K., & Aggarwal, D. (2018). Dietary Practices and Beliefs in Patients With Inflammatory Bowel Disease. Inflammatory Bowel Diseases, 24(1), 11–25. DOI: 10.1093/ibd/izx019
4. Gearry, R. B., Irving, P. M., & Barrett, J. S. (2009). Reduction of Dietary Poorly Absorbed Short-Chain Carbohydrates (FODMAPs) Improves Abdominal Symptoms in Patients With Inflammatory Bowel Disease—A Pilot Study. Journal of Crohn’s and Colitis, 3(1), 8–14. DOI: 10.1016/j.crohns.2008.09.004
5. Hou, J. K., Lee, D., Lewis, J. (2014). Diet and Inflammatory Bowel Disease: Review of Patient-Targeted Recommendations. Clin Gastroenterol Hepatol, 12(10), 1592–1600. DOI: 10.1016/j.cgh.2013.09.063
Conclusion
The study lays bare the complexities of dietary management in IBD and underscores the necessity for reliable, accessible nutritional guidance. With IBD patients already grappling with the disruption of daily life due to their condition, the additional challenge of managing diet without professional guidance compounds the difficulty of maintaining well-being. Healthcare systems need to prioritize evidence-based, patient-centered nutritional education and counseling to empower individuals to make informed dietary decisions that bolster their health rather than detract from it.