J Neurogastroenterol Motil  
Use of Dietary Management in Irritable Bowel Syndrome: Results of a Survey of over 1500 United States Gastroenterologists
Adrienne Lenhart,1 Courtney Ferch,2 Michael Shaw,3 and William D Chey4*
1Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA; 2Spectrum Health System, Grand Rapids, MI, USA; 3Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical School, Minneapolis, MN, USA; and 4Digestive Disorders Nutrition & Lifestyle Program, Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA
Correspondence to: William D Chey, MD
Digestive Disorders Nutrition & Lifestyle Program, Division of Gastroenterology, University of Michigan Health System, 3912 Taubman Center, SPC 5362, Ann Arbor, MI 48109-5362, USA
Tel: +1-734-936-4775, Fax: +1-734-936-7392, E-mail: wchey@umich.edu
Received: September 19, 2017; Revised: November 13, 2017; Accepted: February 19, 2018; Published online: June 8, 2018.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

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Abstract
Background/Aims
Dietary therapy is increasingly used to manage gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). We aim to gauge United States gastroenterologists’ perceptions of dietary therapies for IBS.
Methods
We distributed a 22-question survey to members of the American College of Gastroenterology. The survey was developed by gastroenterologists and survey methodologists. We collected information pertaining to demographics, providers’ interpretation of their patients’ views on dietary therapy, and gastroenterologists’ perceptions on dietary therapy, and nutritional counseling in IBS.
Results
One thousand five hundred and sixty-two (14%) surveys were collected. Nearly 60% of participants reported that patients commonly associate food with GI symptoms. IBS patients most commonly use a trial and error approach followed by a lactose-free and gluten-free diet, and rarely use a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet on their own. Over half of providers recommend diet therapy to > 75% of IBS patients and most commonly recommend a low FODMAP diet. Only 21% of gastroenterologists commonly refer IBS patients to registered dietitians, and only 30% use GI dietitians. Female providers were more likely than males to recommend dietary changes as the primary mode of therapy (OR, 1.43 [1.09-1.88]; P = 0.009).
Conclusions
Our national survey identified enthusiasm for diet treatment of IBS. While patients infrequently tried a low FODMAP diet on their own, GI providers commonly recommended this diet. Only a minority of GI providers refer their IBS patients to a registered dietitian for nutrition counseling and few refer patients to dietitians with specialized GI training. Female providers were more enthusiastic about diet therapies than males.
Keywords: Dietitian; Diet therapy; Irritable bowel syndrome


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