Assessment of Quality and Readability of Internet Dietary Information on Irritable Bowel Syndrome

Alfaro-Cruz, Ligia; Kaul, Isha; Yan, Zhang; Shulman, Robert J.; Chumpitazi, Bruno P.

doi:10.1016/j.cgh.2018.05.018

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…There is increasing evidence that internet-based strategies may be of value in the treatment of gastrointestinal diseases. There are several websites and software applications providing information on the low-FODMAP diet, but the information is often of low quality with a wide variety of recommendations (76,77). The advantages of software applications and home monitoring include offering the patient quick and easy access to nutritional advice and providing patients with more individualized treatment (78).…”

Section: Description Of Professional Guidance During the Dietary Trea...mentioning

confidence: 99%

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Thomassen

Luque

Assa

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Excluding oligo-, di-, monosaccharides and polyols (FODMAPs) from the diet is increasingly being used to treat children with gastrointestinal complaints. The aim of this position paper is to review the available evidence on the safety and efficacy of its use in children and provide expert guidance regarding practical aspects in case its use is considered. Members of the Gastroenterology Committee, the Nutrition Committee and the Allied Health Professionals Committee of the European Society for Pediatric Gastroenterology Hepatology and Nutrition contributed to this position paper. Clinical questions regarding initiation, introduction, duration, weaning, monitoring, professional guidance, safety and risks of the diet are addressed. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. The systematic literature search revealed that the low-FODMAP diet has not been comprehensively studied in children. Indications and contraindications of the use of the diet in different pediatric gastroenterological conditions are discussed and practical recommendations are formulated. There is scarce evidence to support the use of a low-FODMAP diet in children with Irritable Bowel Syndrome and no evidence to recommend its use in other gastrointestinal diseases and complaints in children. Awareness of how and when to use the diet is crucial, as a restrictive diet may impact nutritional adequacy and/or promote distorted eating in vulnerable subjects. The present article provides practical safety tips to be applied when the low-FODMAP diet is considered in children.

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Section: Description Of Professional Guidance During the Dietary Trea...mentioning

confidence: 99%

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

Thomassen

Luque

Assa

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…This is consistent with gastroenterologists reporting that over half of their patients with irritable bowel syndrome attempt to self‐manage their symptoms with dietary interventions, most often using a “trial and error” approach 8 . The frequency of self‐initiated diets may also be due growing availability of online resources about dietary interventions and the increased production and marketing of specialty food products (e.g., gluten‐free, vegan), but concerns remain about both the quality of this content 45 and lack of dietetic supervision 46,47 . We also found that almost half of exclusion diets had been documented as recommended by a provider, with 30% of all reported diets recommended by a GI provider.…”

Section: Discussionmentioning

confidence: 71%

History of trying exclusion diets and association with avoidant/restrictive food intake disorder in neurogastroenterology patients: A retrospective chart review

Atkins

Zar-Kessler

Madva

et al. 2023

Neurogastroenterology Motil

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Background: Exclusion diets for gastrointestinal symptom management have been hypothesized to be a risk factor for avoidant/restrictive food intake disorder (ARFID; a non-body image-based eating disorder). In a retrospective study of pediatric and adult neurogastroenterology patients, we aimed to (1) identify the prevalence and characteristics of an exclusion diet history and (2) evaluate if an exclusion diet history was concurrently associated with the presence of ARFID symptoms. Methods:We conducted a chart review of 539 consecutive referrals (ages 6-90, 69% female) to adult (n = 410; January-December 2016) and pediatric (n = 129; January 2016-December 2018) neurogastroenterology clinics. Masked coders (n = 4) retrospectively applied DSM-5 criteria for ARFID and a separate coder assessed documentation of exclusion diet history. We excluded patients with no documentation of diet in the chart (n = 35) or who were not orally fed (n = 9).Results: Of 495 patients included, 194 (39%) had an exclusion diet history, and 118 (24%) had symptoms of ARFID. Of reported diets, dairy-free was the most frequent (45%), followed by gluten-free (36%). Where documented, exclusion diets were selfinitiated by patients/parents in 66% of cases, and recommended by gastroenterology providers in 30%. Exclusion diet history was significantly associated with the presence of ARFID symptoms (OR = 3.12[95% CI 1.92-5.14], p < 0.001). Conclusions: History of following an exclusion diet was common and was most oftenpatient-initiated among pediatric and adult neurogastroenterology patients. As patients with self-reported exclusion diet history were over three times as likely to have ARFID symptoms, providers should be cognizant of this potential association when considering dietary interventions. K E Y W O R D Savoidant/restrictive food intake disorder, disorders of gut-brain interaction, feeding and eating disorders, functional gastrointestinal disorders How to cite this article: Atkins M, Zar-Kessler C, Madva EN, et al. History of trying exclusion diets and association with avoidant/restrictive food intake disorder in neurogastroenterology patients: A retrospective chart review.

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“…This is a particular concern, as a majority of patients prefer to receive medical information directly from healthcare physicians rather than from the internet, handouts, or books 23 . Unfortunately, for those subjects with FGIDs who do search for diet information on the internet, the information is often of low quality with a wide variety of recommendations provided 24 . Additionally, further research is needed to determine the most efficacious, practical diet(s) and nutrition interventions using evidence‐based principles.…”

Section: Discussionmentioning

confidence: 99%

Does a Minority of Children With Functional Gastrointestinal Disorders Receive Formal Diet Advice?

Cruz

Minard

Guffey

et al. 2020

J Parenter Enteral Nutr

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Background: Diet therapies may be recommended for pediatric functional gastrointestinal disorders (FGIDs). However, little is known about the frequency with which diet therapy is recommended in FGIDs. Our aims were to determine and contrast the frequency and types of diet recommendations provided to children with FGIDs by pediatric gastroenterologists (PGIs) versus primary care pediatricians (PCPs). Methods: A retrospective chart review was performed using data from a large, metropolitan children's academic healthcare system to identify subjects meeting Rome IV criteria for functional abdominal pain, functional dyspepsia, irritable-bowel syndrome (IBS), and/or abdominal migraine over a period of 23 months. Results: Of 1929 patient charts reviewed, 268 were included for further analyses. Of these, 186 patients (69%) were seen by a PGI and 82 (31%) by a PCP. The most common diagnosis was IBS (49% for PGIs and 71% for PCPs). Diet recommendations were provided to 115 (43%) patients (PGI group: 86 [75%] vs PCP group: 29 [25%]; P < .1). The most frequent recommendations were high fiber (PGI: 15%; PCP: 14%) and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet (PGI: 12%; PCP: 4%). Of those provided with diet recommendations, only 20% (n = 23) received an educational consult by a dietitian. Provision of diet recommendations was not affected by years in practice. Conclusion: Despite increasing awareness of the role of diet in the treatment of childhood FGIDs, a minority of patients receive diet recommendations in tertiary care or primary care settings. When diet recommendations were given, there was great variability in the guidance provided.

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Assessment of Quality and Readability of Internet Dietary Information on Irritable Bowel Syndrome

Cited by 7 publications

References 5 publications

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology

History of trying exclusion diets and association with avoidant/restrictive food intake disorder in neurogastroenterology patients: A retrospective chart review

Does a Minority of Children With Functional Gastrointestinal Disorders Receive Formal Diet Advice?

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