Abstract
There is a lack of dietitians trained to deliver the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (LFD) for irritable bowel syndrome (IBS). Many patients receive nutritional information from general practitioners (GPs) or gastroenterologists (GEs). Since the LFD is dietitian-led, the aim of this research was to qualitatively explore the effects of GP- and GE-delivered LFD information, in IBS self-management. Semi-structured interviews were conducted in a purposive sample of 8 people with IBS (6 female), who used the LFD as their primary treatment. Interpretive Phenomenological Analysis (IPA) was used to develop themes on the lived experience of the participant’s use of LFD information from GPs and GEs. This information was perceived as trustworthy but simplistic; often just ”food lists” with little personalisation to meet individual needs and difficult to apply in ”real life”. The information required substantial interpretation and the familial and social effects of implementation were not addressed in the materials provided. Supplementary digital resources were regarded as more practical but the participants expressed concern in relation to the validity of these materials. The findings in this study support current clinical guidelines proposed by both the National Institute for Health and Care Excellence and the British Dietetic Association that the LFD should be considered a dietitian-led only intervention.
Highlights
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that manifests with symptoms of abdominal pain and altered bowel habit in the absence of abnormal findings on routine clinical tests explaining the symptoms [1]
The aim of this research was to qualitatively explore the lived experience of how people with IBS use and apply low FODMAP diet (LFD) nutritional information provided by general practitioners (GPs) and GEs to self-manage their symptoms
A distinctive feature of Interpretive Phenomenological Analysis (IPA) is its commitment to depth of analysis, and it aims to provide a detailed account of individual cases and inherently requires small sample sizes [46]
Summary
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that manifests with symptoms of abdominal pain and altered bowel habit in the absence of abnormal findings on routine clinical tests explaining the symptoms [1]. The world-wide prevalence of IBS is 11.2% [2]. It is thought that IBS results from abnormalities of the “gut–brain axis” (a bidirectional circuit of communication between the gut and the brain) that may involve both mucosal and neuro-inflammation [6,7,8,9,10,11]. Nutrition appears to play an important role in IBS, both in exacerbating (approximately 60% of patients) or providing relief of symptoms [12,13,14,15,16]
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