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Background: Evidence suggests that the low fermentable oligo‐, di‐, mono‐saccharides, and polyols (FODMAP) diet improves irritable bowel syndrome (IBS) symptoms when delivered by a dietitian. However, demand for dietetic appointments exceeds supply. Prerecorded webinars are acceptable and cost‐effective for delivering first‐line IBS dietary advice. Methodology: This study, using a pre–post design, aimed to evaluate the effectiveness of a low‐FODMAP diet restriction phase webinar at improving IBS symptoms. Participants with self‐reported IBS symptoms were asked to report their IBS symptoms, stool frequency, stool consistency and IBS medication use, before and 8 weeks postwebinar via an online questionnaire. The presence and severity of participants' symptoms and bowel habits were captured using validated tools and a global symptom question. Results: In total 228 participants responded to both pre‐ and postsurveys. A statistically significant improvement in all symptoms was observed 8 weeks postwebinar (p < 0.05). The proportion of participants rating their overall symptoms as moderate‐to‐severe reduced from 85.5% at baseline to 34.6% postwebinar (50.9% reduction [p < 0.001]). The proportion of participants reporting normal stool consistency and frequency significantly increased postwebinar (23.2%–39.9% [p < 0.001] and 76.3%–89% [p < 0.001], respectively). Satisfactory relief of symptoms increased from 16.7% to 53.1%, (p < 0.001) 8 weeks postwebinar. Conclusions: These results are comparable with literature on the efficacy of face‐to‐face delivery of low‐FODMAP diet education. Dietitians should consider directing triaged patients with IBS, who have tried first‐line dietary advice, to this webinar as an alternative or alongside current practice. Key points: The low fermentable oligo‐, di‐, mono‐saccharides, and polyols (FODMAP) diet has been shown to be effective in alleviating symptoms of irritable bowel syndrome (IBS) when administered by a dietitian. However, demand for dietetic appointments currently exceeds capacity.Prerecorded webinars have been shown to be a cost‐effective and acceptable method for delivering first‐line IBS dietary advice in previous research.This study aimed to evaluate the effectiveness of a dietitian‐developed low‐FODMAP diet webinar in improving IBS symptoms. Participants with self‐reported IBS symptoms (n = 228) completed online questionnaires before and 8 weeks after viewing the webinar.There was a statistically significant improvement across all IBS symptoms (p < 0.05) 8 weeks postwebinar.The proportion of participants rating their overall symptoms as moderate‐to‐severe reduced from 85.5% at baseline to 34.6% postwebinar (50.9% reduction [p < 0.001]).The proportion of participants reporting normal stool consistency and frequency significantly increased postwebinar (23.2%–39.9% (p < 0.001) and 76.3%–89% (p < 0.001).Satisfactory relief of symptoms increased from 16.7% to 53.1%, (p < 0.001) 8 weeks postwebinar.These findings align with previous research on the efficacy of face‐to‐face dietitian delivery of low‐FODMAP diet education, and the use of prerecorded webinars supports the objectives of the long‐term plan of the NHS to digitise healthcare and reduce the number of outpatient appointments.Dietitians should consider signposting triaged patients with IBS to the low‐FODMAP diet webinar as an alternative or to supplement current practice.Long‐term follow‐up of this cohort will be explored in future research to determine how long participants experienced satisfactory relief from symptoms. [ABSTRACT FROM AUTHOR]

Aim: To explore patients' follow-up preferences. Background: Optimal follow-up strategies for patients with coeliac disease remain a subject of debate. Research suggests patients' prefer review by dietitians with a doctor available as required. Methods: Patients with coeliac disease under review at our centre, completed a questionnaire assessing their views on what makes follow-up useful based on specific criteria. Bloods tests, symptoms review, dietary assessment, opportunity to ask questions and reassurance. Patients' preferences between follow-up with a hospital doctor, a hospital dietitian, a hospital dietitian with a doctor available, a general practitioner, no follow-up or access when needed were also evaluated. Results: 138 adult patients completed the questionnaire, 80% of patients reported following a strict gluten free diet (mean diagnosis was 7.2 years). Overall, 60% found their follow-up to be 'very useful' valuing their review of blood tests and symptoms (71%) reassurance (60%) and opportunity to ask questions (58%). Follow-up by a dietitian with a doctor available was the most preferred option of review (p<0.001) except when compared to hospital doctor (p=0.75). Novel modalities of follow-up such as telephone and video reviews were regarded as of equal value to face-to-face appointments (65% and 62% respectively). Digital applications were significantly less preferable (38%, p<0.001). Conclusion: Follow-up by a dietitian with a doctor available as needed was the most preferred follow-up method. However, in this study follow-up by a dietitian with doctor available and hospital doctor alone was statistically equivalent. Many patients consider telephone and video follow-up of equal value to face-to-face reviews. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that dietary interventions can improve symptoms in people with irritable bowel syndrome (IBS), although most data explore the short‐term (immediate) impact. Data on long‐term (>6 months) impact are limited, especially from primary care settings. The present study aimed to investigate the long‐term effect of dietetic‐led interventions for IBS delivered in primary care. Methods: A service evaluation of a dietetic‐led IBS clinic was completed, analysing data on symptom severity, stool frequency and consistency, and healthcare input. Data were collected before and immediately after dietary intervention as part of patients' routine clinical appointments. Long‐term data were collected via a postal questionnaire at least 11 months later. Results: In total, 211 patients responded to the long‐term follow‐up questionnaire at a median of 13 months (interquartile range 12–16 months) post follow‐up appointment. Of these, 84% had been advised to follow a low FODMAP (i.e., fermentable oligosaccharides, disaccharides, monosaccharides and polyols carbohydrates) diet. All symptoms were reported significantly less frequently short term, and all except heartburn and acid regurgitation remained so over the long term. The four most commonly reported bowel symptoms reduced in frequency were abdominal pain (62%), bloating (50%), increased wind (48%) and urgency to open bowels (49%) (p < 0.001). The percentage of patients reporting satisfactory relief of gut symptoms was 10% at baseline and 55% at long‐term follow‐up (p < 0.001). Visits to a general practitioner were reduced (from 96% to 34%; p < 0.001), as were those to the gastroenterologist (from 37% to 12%; p = 0.002), during the year prior to long‐term follow‐up compared to the year prior to dietary intervention. Conclusions: Patients with IBS who received dietetic‐led interventions in primary care reported long‐term symptoms improvements that may result in reduced healthcare usage. [ABSTRACT FROM AUTHOR]

Background & Aims: Diet appears to play a pivotal role in symptom generation in Irritable Bowel Syndrome (IBS). First line dietary therapy for IBS has focused on advice concerning healthy eating and lifestyle management. Research recently has focused on the role of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs), gluten free (GFD) and wheat free (WFD) diets for the relief of symptoms in IBS. Methods: A round table discussion with gastroenterologists and dietitians with a specialist interest in dietary therapies in IBS was held in Sheffield, United Kingdom in May 2017. Existing literature was reviewed. PubMed and EMBASE were searched with the MeSH terms irritable bowel syndrome/diet/diet therapy/gluten/low FODMAP in different combinations to identify relevant articles. A consensus on the application of these dietary therapies into day-to-day practice was developed. Results: Fourteen randomized trials in IBS evaluating the low FODMAP diet (n studies = 9), GFD (n = 4) and WFD (n = 1) were included in this review. The total number of patients recruited from randomized trials reviewed was: n=580 low FODMAP diet (female, n=430), n=203 GFD (female, n=139), n=276 WFD (female, n=215). There was no significant difference in the gender of patients recruited for both the low FODMAP and GFD randomized studies (p=0.12). The response rate in the literature to a low FODMAP diet ranged between 50-76%, and to GFD ranged between 34-71%. Percentage of IBS patients identified as wheat sensitive was reported as 30% in the literature. Conclusion: There are no head-to-head trials to date utilizing the low FODMAP diet, GFD and WFD for dietary treatment of IBS and still a number of concerns for diets, including nutritional inadequacy and alteration of the gut microbiota. The consensus suggests that there is evidence for the use of the low FODMAP diet, GFD and WFD as dietary therapies for IBS; the decision-making process for using each individual therapy should be directed by a detailed history by the dietitian, involving the patient in the process. [ABSTRACT FROM AUTHOR]