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Small bowel and nutrition
Original research
Dietary beliefs and recommendations in inflammatory bowel disease: a national survey of healthcare professionals in the UK
  1. Benjamin Crooks1,2,3,
  2. John McLaughlin1,2,
  3. Jimmy Limdi1,3
  1. 1Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
  2. 2Department of Gastroenterology, Salford Royal NHS Foundation Trust, Salford, UK
  3. 3Section of IBD - Division of Gastroenterology, The Pennine Acute Hospitals NHS Trust Gastroenterology, Manchester, UK
  1. Correspondence to Dr Benjamin Crooks, Division of Diabetes, Endocrinology and Gastroenterology, The University of Manchester Faculty of Biology Medicine and Health, Manchester M139PL, UK; b.crooks1{at}nhs.net

Abstract

Background The role of diet in inflammatory bowel disease (IBD) remains incompletely understood. Knowledge around the actual dietary advice healthcare professionals provide to individuals with IBD is scarce. Our objective was to describe the dietary beliefs of healthcare professionals and dietary recommendations made to people with IBD.

Methodology An online survey regarding IBD-related dietary beliefs and advice provided to patients was distributed to gastroenterologists, dietitians and IBD nurses in the UK.

Results Two-hundred and twenty-three eligible healthcare professionals participated: 107 (48%) believed that diet was involved in IBD development. The most frequently implicated dietary components were processed foods (78%), additives/preservatives (71%), sweet/sugary foods (36%), red meat (36%) and fatty foods (31%). Views were broadly consistent across professions, however, gastroenterologists were significantly more likely to believe red meat and additives/preservatives initiated IBD. One hundred and thirteen participants (53%) believed that diet could trigger disease relapse and 128 (61%) recommended limiting specific foodstuffs to reduce this risk, most commonly high fibre foods. Forty-six (23%) considered recommending a low Fermentable Oligo-, Di- and Monosaccharides and Polyols diet to reduce relapse risk. IBD nurses and healthcare professionals with <5 years experience were most likely to recommend this. Dietitians felt most comfortable providing dietary advice for functional gastrointestinal symptoms in quiescent IBD.

Conclusion Dietary advice in IBD is inconsistent reflecting uncertainty among healthcare professionals. While some consensus exists regarding dietary components implicated in IBD development and relapse, dietary recommendations varied. Future research is required to disentangle these complex relationships, alongside better training and education.

  • inflammatory bowel disease
  • diet
  • ulcerative colitis
  • crohn's disease

https://doi.org/10.1136/flgastro-2020-101723

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    Footnotes

    • Contributors BC: Study design and setup, distribution of survey, analysis of data, first draft of manuscript and subsequent revisions. JM: Study design and setup, distribution of survey, revised and edited the initial draft of the manuscript. JL: Study design and setup, distribution of survey, revised and edited the initial draft of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JL has received consultancy and speaker fees from Abbvie, MSD, Janssen, Takeda and Pfizer.

    • Patient consent for publication Not required.

    • Ethics approval The study was exempt from need for ethical review by the Health Research Authority.

    • Data availability statement Data are available on reasonable request from the corresponding author.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.