S3189 Can Plant-Based Diet Help IBD: What Does the Internet Tell Patients?

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) is characterized by inflammation of the gastrointestinal tract and thought to be triggered by environmental and genetic factors. Emerging data suggests a plant based diet (PBD) may help IBD patients maintain remission by increasing microbial diversity and decreasing inflammation. Individuals with IBD often seek online sources for self-education. This study evaluated the quality, readability, and content of readily accessible online resources on PBD for IBD treatment using validated assessment tools. METHODS: An internet google search was conducted with the terms “plant based diet and inflammatory bowel disease” to obtain the first 100 websites. Websites were excluded if they were inaccessible, videos without transcripts, forums or duplicates. Sites were categorized by intended audience: patient or professional. Quality was evaluated using the validated DISCERN instrument, with scores rated as Excellent 56–75, Good 36–55 or Poor <36. Readability was determined using the validated Flesch-Kincaid Grade Level Calculation. Statistical analysis was conducted using a two-tailed Fisher’s Exact Test and a Two-Sample T-test, with a P-value set at < 0.05. RESULTS: 81 of 100 websites met inclusion criteria and were evaluated. 62 (76.5%) sites were intended for patients and 19 (23.1%) were for medical professionals. The average Flesch-Kincaid grade level was 9.7 (patient sites 9.3; professional sites 10.3) with no significant difference (P = 0.31) between patient and professional sites. The mean DISCERN quality score was 47.7 (patient sites 44.3; professional sites 58.7). There was a significant difference (P = 0.0001) between patient and professional sites. Patient focused sites were less likely to report potential adverse effects of a plant based diet (29% vs 58%, P = 0.009), include clear references (63% vs 95%, P = 0.0001), and acknowledge areas of uncertainty (44% vs 84%, P = 0.0031), but were as likely to describe alternative treatments as professional sites (55% v 74%, P = 0.19). CONCLUSION: Online information on PBD and IBS is readily available for patients and professionals. Based on the validated DISCERN tool, the quality of website information was rated as good, but readability exceeded the NIH 6th grade reading level recommendation. This suggests patients may have trouble interpreting quality information. It is critical that unbiased resources that acknowledge uncertainty and use patient-centered language are available to facilitate informed decision making.