目的:对肠易激综合征(IBS)的饮食治疗越来越重视。此外,有一个不断发展的证据基础的低可发酵寡糖,二糖,单糖和多元醇(FODMAP)饮食,无麸质饮食(GFD),和无乳糖饮食。这项研究探讨了采用的饮食方法以及影响IBS干预饮食决策的因素。
方法:参与者,包括注册营养师和营养师,在第四届谢菲尔德全国饮食胃肠病学研讨会的注册点从不同的医疗机构招募,2023年。一项15个问题的在线调查调查了营养师和营养师在管理IBS患者方面的做法,涵盖饮食方法,决策因素,和病人的教育。提供了不同饮食干预措施的证据基础,并对研讨会与会者进行了后续调查评估,对当前IBS饮食习惯的看法。
结果:在731名受访者中,主要是注册营养师(93%)和女性(93%),54%的患者在IBS上花费了10-50%的临床时间。受访者指出,GFD(34%),低乳糖(32%),传统饮食建议(TDA)(18%)是患者在寻求专业建议前最常用的饮食干预措施.代表们被要求在会议前和会议后对他们的饮食干预偏好进行排名(在提供证据基础之后):TDA会议前75%与会议后87%(p=0.04),纤维改性59%对6%(p<0.0001),低FODMAP25%对10%(p=0.0001),低乳糖12%对62%(p<0.0001)和GFD6%至23%(p<0.0001)。
结论:TDA仍然是营养师的饮食选择。在我们的教育活动之后,低乳糖和无麸质饮食的使用显着增加。影响决策过程的因素是基于患者的可接受性,咨询时间,支持证据基础和饮食触发因素。
OBJECTIVE: There has been a growing emphasis on dietary therapies for irritable bowel syndrome (IBS). Furthermore, there has been an evolving evidence base for the low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet, gluten-free diet (GFD), and lactose-free diet. This study examines the dietary approaches employed and the factors influencing dietetic decision-making for IBS interventions.
METHODS: Participants, including registered dietitians and
nutritionists, were recruited from diverse healthcare settings at the point of registration for the 4th Sheffield National Dietetic Gastroenterology Symposium, 2023. A 15-question online survey investigated the practices of dietitians and
nutritionists in managing IBS patients, covering dietary approaches, decision-making factors, and patient education. The evidence base for different dietary interventions was provided and a follow-up survey assessed symposium attendees, views on current IBS dietary practices.
RESULTS: Out of 731 respondents, primarily registered dietitians (93%) and females (93%), 54% spent 10-50% of clinic time on IBS. Respondents noted that a GFD (34%), low lactose (32%), and traditional dietary advice (TDA) (18%) were the most frequently used dietary interventions that patients try before seeking professional advice. Delegates were asked to rank their dietary intervention preferences pre- and post-meeting (after the evidence base had been presented): TDA pre-meeting 75% versus post-meeting 87% (p=0.04), fibre modification 59% versus 6% (p<0.0001), low FODMAP 25% versus 10% (p=0.0001), low lactose 12% versus 62% (p<0.0001) and GFD 6% to 23% (p<0.0001).
CONCLUSIONS: TDA remains the choice of diet for dietitians. After our educational event, the use of low-lactose and gluten-free diet significantly increased. Factors influencing the decision-making process were based on patient acceptability, counselling time, supporting evidence base and dietary triggers.