Most GIs believe IBS diets ‘as good or better’ than medical therapy
The majority of gastroenterologists in the United States believe that diet therapy can be as good as, if not better than, available medical therapies for irritable bowel syndrome, according to the results of a survey published in the Journal of Neurogastroenterology and Motility.
William Chey, MD, of the division of gastroenterology at the University of Michigan Health System, and colleagues wrote that dietary interventions are becoming an increasingly common way to treat the gastrointestinal symptoms of patients with IBS. The purpose of the survey was to determine the perception of dietary therapies among GIs in the United States.
“This is the largest survey conducted amongst United States gastroenterologists that assesses the role of dietary therapies for patients with IBS,” Chey told Healio Gastroenterology and Liver Disease. “What’s clear from the survey is that gastroenterologists have embraced diet therapies for patients with IBS. In fact, the vast majority recommend dietary therapies to their patients with IBS, and more than half actually view diet as a primary therapy for IBS.”
Researchers emailed a 22-question survey to 10,952 physician members of the American College of Gastroenterology and they received 1,417 complete responses and 145 partial responses (n = 1,562). The survey included questions about demographics, nutritional counselling in IBS and each provider’s interpretation of their patients’ views on dietary therapy, as well as their own views on dietary therapy.
Chey said they were surprised to discover that 45% of the responding physicians believed that the effectiveness of dietary therapy was “about the same” compared with medical therapy for IBS. Another 41% indicated that they thought it was “better” and 5% thought it was “much better.”
“We were stunned to find out that 46% said that dietary therapy was more effective than available medical therapies,” Chey said. “When you put that together, 91% felt that diet was as good or better than medical therapies for IBS.”
Investigators also noted a stark difference in the kind of diets that were recommended by GIs compared with the kinds self-prescribed by patients prior to meeting with a doctor.
Patients were more likely to try trial-and-error diets (50%), lactose-free diets (33%) and gluten-free diets, while very few tried low FODMAP diets (2%). The low FODMAP diet was the most common physician-recommended diet (77%), followed by high-fiber (45%), lactose-reduced (45%), low fat (18%) and gluten-free (12%).
“There’s this dichotomy of what patients are doing on their own and what gastroenterologists are recommending,” Chey said.
Although more than half the GIs recommend diet therapy to their patients with IBS, only 21% referred them to a dietician, and only 30% use a dietician with specialized gastrointestinal training.
Chey and colleagues wrote that their findings show a need for more patient education about the low FODMAP diet, as well as a need for more dieticians who are knowledgeable in the dietary management of IBS. - by Alex Young
Disclosures: The researchers report no relevant financial disclosures.