The Role of the Dietitian vs. The Gastroenterologist in Managing Irritable Bowel Syndrome 

Up to 15% of the global population has Irritable Bowel Syndrome (IBS), and it is believed that many more are undiagnosed. In the best case scenario for managing IBS symptoms, two key players come into focus: the Gastroenterologist and the Registered Dietitian (RD). They each play distinct but complementary roles in helping individuals cope with the challenges of IBS. In this article, we will delve into the unique responsibilities of these healthcare professionals and explore why their collaboration is essential for your success. We see the role of the dietitian severely underestimated and misunderstood.

Do You Need the Support & Guidance of a Dietitian If You Have a Gastroenterologist?

We say YES! Statistically and anecdotally, you have a far greater chance of success if you work with a Registered Dietitian (RD). But what is the role of the RD if you’ve been diagnosed with IBS? Do you really need one, and if so, why?

Get a Diagnosis From a Gastroenterologist

A Gastroenterologist (GI) is a physician (medical doctor – MD) who specializes in diseases of the gastrointestinal tract and liver. They can diagnose and treat various gastrointestinal conditions, including IBS. However, the limits of their specific role in relation to certain treatments, such as the low FODMAP diet for IBS, need clarification.

Do Not Self Diagnose IBS Or Any Digestive System Issues

It’s crucial not to self-diagnose yourself with IBS because there are many other medical issues with similar symptoms. Conditions like celiac disease, endometriosis, ulcerative colitis, diverticulitis, and even life-threatening illnesses can mimic IBS symptoms. To ensure an accurate diagnosis, consult a Gastroenterologist who can conduct the necessary tests and rule out other medical problems.

How Is IBS Diagnosed?

IBS is diagnosed based on a thorough examination of your medical history and symptoms. There isn’t a single direct test for IBS, so specialists like Gastroenterologists, who have seen various symptom presentations, are best equipped to make an accurate diagnosis. You might need a referral from your General Practitioner (GP) to see a Gastroenterologist.

Gastroenterologists & IBS Treatment Plans

Suppose you’ve received an IBS diagnosis from a GI, and they’ve suggested the low FODMAP diet as part of your treatment plan. The low FODMAP diet can be an effective way to minimize, or even eliminate, IBS symptoms in up to 75% of those with IBS, so it is a common recommendation. But, many if not most gastroenterologists do not understand the nuances of the diet and may make unhelpful suggestions.

For instance, probiotics and digestive enzymes should not be taken while embarking on the low FODMAP diet. The diet is also not suitable for everyone with IBS. In addition, there are IBS sub-types that the gastroenterologist very often does not explain. None of this is a surprise, or a problem. It is not the GI’s scope of knowledge. This is where a Registered Dietitian comes in.

Where the Role of The Gastroenterologist Fades Out

Your GI might have been given you a handout with lists of “high FODMAP foods” and “low FODMAP foods.” and told you to “go do the diet”, however, many patients find themselves lost after this point.

The Gastroenterologist’s primary job is to provide a diagnosis and offer preliminary recommendations for treatment. However, it’s important to note that GIs may not consistently recommend working with a Registered Dietitian (RD) as part of the treatment plan, and the diet was always meant to be undertaken along with a dietitian. This gap between diagnosis and successfully implementing the low FODMAP diet can leave patients seeking guidance.

What Is A Registered Dietitian?

Firstly, what is a Registered Dietitian (RD)? In the U.S., they may also be referred to as RDNs (Registered Dietitian Nutritionists), and internationally as Accredited Practising Dietitians (APDs). RDs are highly trained and skilled healthcare professionals who differ significantly from “nutritionists,” “health coaches,” and other nutrition-related roles. The term “nutritionist” is unregulated. Do not put your nutritional future into the hands of someone is not formally trained and accredited.

The Role Of The Dietitian

Dietitians take a personalized approach to digestive health, considering the big picture. If you have additional health issues like GERD, diabetes, weight concerns, or specific dietary preferences (vegan, for example), working with a dietitian becomes crucial. RDs utilize dietary guidelines, and their personal clinical experience, to provide personalized recommendations, including dietary changes such as the low FODMAP diet when appropriate.

Dietitians Really Get to Know You

Dietitians spend significant time with clients, allowing for a detailed investigation of symptoms and tailored guidance. They may suggest specific tests to help further diagnose or rule out issues, although they cannot prescribe medications or carry out tests themselves. Dietitians ensure that patients do not suffer from malnutrition, which is a concern with elimination diets, and help foster a positive relationship with food, addressing emotional aspects as well.

For instance, a GI might not be aware that a patient has an eating disorder, or is prone to disordered eating, and might recommend the low FODMAP diet. A dietitian would uncover these issues and suggest a better approach.

What Conditions Do Dietitians Help With?

Dietitians are trained to provide support for various conditions, including diabetes, Crohn’s disease, inflammatory bowel disease (IBD), weight management, food allergies, and, importantly, functional gastrointestinal disorders such as IBS. Many individuals with IBS also deal with concurrent medical issues, making the expertise of a dietitian invaluable in managing their diet across multiple concerns.

How To Choose A Dietitian

Selecting the right dietitian is essential for effective guidance and support. Look for RDs with experience in the low FODMAP diet, as this specialized knowledge can be beneficial. Numerous credible websites offer dietitian directories, such as FODMAP Everyday®. Additionally, consider dietitians who offer remote consultations, as this allows for more flexibility in finding the right fit for your needs.

Take Time to Find the Right RD For You

Meeting with a dietitian is a personalized experience where they work closely with you to ensure that your diet aligns with your lifestyle, preferences, and specific health issues. They provide guidance on daily meal planning, ensuring that you can enjoy your favorite foods while adhering to dietary recommendations.

The Takeaway

Both Gastroenterologists and Registered Dietitians play vital roles in managing IBS. The Gastroenterologist provides the initial diagnosis and recommends treatment options, including the low FODMAP diet. However, working with a Registered Dietitian is essential to ensure that your dietary choices are personalized, nutritionally sound, and emotionally supportive. By collaborating with both professionals, you will improve your chances of effectively managing IBS and your overall quality of life.