Kate Scarlata, MPH, RD1, William D. Chey, MD, FACG2, Shanti Eswaran, MD3; 1For a Digestive Peace of Mind, LLC, Medway, MA; 2University of Michigan Health System, Ann Arbor, MI; 3University of Michigan, Ann Arbor, MI
Introduction: Despite growing interest in the efficacy of nutritional interventions for irritable bowel syndrome (IBS), the utilization of registered dietitians (RDs) in the US has not been well characterized. The primary aim of this study was to identify benefits and barriers to utilizing a dietitian for IBS care. Methods: A 25-question survey, developed by a team of expert gastroenterologists and a dietitian, was electronically distributed to members of the American College of Gastroenterology via 3 emails between February 2, 2020 and March 17, 2020. Information pertaining to demographics, perceived knowledge base for providing nutrition education, time spent on nutrition education was collected, as well as obstacles and value of utilizing a dietitian for IBS patient care. Results: 279 survey responses were collected. The cohort included 68% men, with 42% practicing in the field of gastroenterology for over 20 years, and more than half (53%) consulting with IBS patients in a community-based setting. Although two thirds of IBS patients asked about diet during their initial visit with a GI provider, 77% of providers spent ≤10 minutes of a new patient visit for IBS providing nutrition counseling. Nearly half of GI providers felt inadequately trained to provide nutrition counseling. Almost half (46%) sometimes, rarely or never provided information to aid menu planning, label reading or grocery shopping. Though 62% of practitioners usually or always discussed the 3 phases of the low FODMAP diet (LFD) with their IBS patients, more than a third (35%) did not. Ninety-one percent strongly agreed or agreed that having access to a GI dietitian would help manage IBS patient care more effectively, but 42% lacked access to a local GI dietitian. Moreover, three fourths strongly agreed or agreed that a GI dietitian would reduce their workload by reducing provider-patient contact hours. Discussion: This survey of the ACG membership identified a number of gaps in the care of IBS patients. A significant minority of GI providers do not have adequate training, education materials, or time to optimally administer the LFD in IBS patients.Though GI providers strongly feel that a GI dietitian can improve IBS outcomes, increase patient satisfaction, and save time, more than 40% don’t have access to a local GI dietitian. Efforts to provide high quality nutrition training for gastroenterologists and dietitians are needed. High quality education materials on the LFD for IBS patients appear to be another unmet need.
Disclosures: Kate Scarlata: A2 milk company – Consultant. Enjoy Life Foods – Consultant. Epicured – Employee, Stockholder/Ownership Interest (excluding diversified mutual funds). FODY food company – Advisory Committee/Board Member, Stockholder/Ownership Interest (excluding diversified mutual funds). Green Valley Creamery – Consultant. Monash University – Consultant. Salix pharmaceuticals – Consultant. William Chey: Allergan – Consultant. Biomerica – Consultant, Grant/Research Support. Commonwealth Diagnostics – Grant/Research Support. iModify Health – Stockholder/Ownership Interest (excluding diversified mutual funds). Ironwood – Consultant. Phathom – Consultant. QOL Medical – Consultant, Grant/Research Support. Redhill – Consultant. Ritter pharmaceuticals – Consultant. Salix pharmaceuticals – Consultant, Grant/Research Support. Urovant – Grant/Research Support. Vibrant – Grant/Research Support. Shanti Eswaran indicated no relevant financial relationships.