THE PRACTICE AND PERCEPTION OF LOW RESIDUE DIETS IN ADULT PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract

Abstract BACKGROUND Low residue diets have been traditionally recommended during disease flares or post-operatively in patients with inflammatory bowel disease (IBD) for the purported benefits of reduced pain or lower risk of bowel obstruction. However, these diets may not be healthy if consumed long-term and can adversely impact quality of life. It remains controversial whether such diets are truly beneficial, and the scale of such dietary practice remains unknown. METHODS A survey was conducted to better understand the practice and the perception related to low residue diet recommendations among patients with IBD at a large academic medical system in the United States. Adult patients (age ≥18) with an established diagnosis of IBD were identified using ICD-10 codes in the electronic medical record system. The survey contained 23 questions and was disseminated electronically from August 2023 to October 2023. RESULTS 132 patients (Crohn’s disease: 59, ulcerative colitis: 68, IBD-unclassified: 5) completed the online survey. The median age was 54 years (IQR 41, 67), with a median disease duration of 15 years (IQR 8, 30). Sixty percent of respondents were female. The majority of respondents (57%) reported currently receiving a biologic therapy. 14 (11%) patients reported currently following a low residue diet, and 34 (25%) reported following the diet in the past. Subjects followed the diet for a median duration of 18 months (IQR 6, 72). Among the 48 patients who followed a low residue diet, 33 (69%) reported using the diet to help with disease flare, while 23 (48%) did so to improve IBD symptoms and an additional 9 patients (19%) reported using a low residue diet post-operatively. 32 (67%) were instructed by their healthcare providers to follow this diet; however, only 4 of them were told not to continue this diet indefinitely. Low residue diets were reported to be “very helpful” (n=14, 29%) or “helpful” (n=18, 38%) in improving IBD symptoms. This benefit consisted of reducing pain (65%), bloating (60%), bowel movement frequency (44%), or urgency (38%). However, respondents noted significant adverse impact on quality of life from a low residue diet: 96% reported that the diet at least moderately limited them from eating foods they enjoyed, and 90% reported that it prevented them from eating what they perceived to be a healthy diet. CONCLUSION Within this cohort of individuals with IBD, 36% of survey respondents either followed or had followed a low residue diet. While up to 65% of individuals felt that this may improve abdominal pain, bloating, or other symptoms, almost all individuals felt such a diet limited their intake of foods they enjoy and from eating a healthy diet. Further education is required for providers regarding screening for low residue diet use and its appropriate indications to reduce its negative impact on quality of life.