In recent years there has been a renewed interest in dietitian-led nutritional treatments for Irritable Bowel Syndrome (IBS)-specifically the Low FODMAP (LFD) and Gluten Free Diets (GFD). Increases in diagnosis and a lack of suitably trained dietitians to deliver these modalities mean many patients only receive nutritional information from General Practitioners (GP’s) and Gastroenterologists (GE’s). Since the LFD and GFD are dietitian-led, the aim of this research was to qualitatively explore how people with IBS use and apply dietary information from GP’s and GE’s in IBS self management.Methods
An initially sample of 33 people (7 male) responded to a research request from the staff and student body of Sheffield University. 10 participants with a median age of 45 years (range 24–64, 2 male) matched the inclusion criteria-diagnosed with IBS (ROME IV) and used diet as their primary treatment. There were no differences in baseline demographics between patients who participated in the study and those who did not (gender p=1.0, age p=0.9). All participants had received dietary information from GP’s and GE’s for self managing their IBS symptoms; primarily advice on the LFD. Semi-structured interviews were conducted (minimum an r duration) and evaluated using Interpretive Phenomenological Analysis (IPA). IPA is a qualitative research method that employs phenomenological, and idiographic techniques to explore and explain participants lived experience. IPA is particularly suited to examine and understand how people with IBS make sense of the dietary information they are given and how this relates to the self-management of their symptoms.Findings
The providence of nutritional information was important for the participants, information from GP’s and GE’s was valued as evidenced based. However, the information was seen as very simplistic, often just ‘food lists’ with little or no personalisation to meet individual needs of the participants (figure 1). Digital online and resources were used to supplement the dietary information received form GP’s and GE’s, however this required additional interpretation and personalisation and led to negative effects on both the participants social and food-related quality of life.Conclusion
The participants found much of the nutritional information provide by GPS’ and GE’s to be overly generic and incomplete; in that it was difficult to apply in ‘real life’. The findings in this study support the current clinical guidelines proposed by the both by NICE and the BDA that LFD and GFD’s should still be considered second-line dietitian-led only interventions.