Year
2025
Season
Spring
Paper Type
Doctoral Dissertation
College
Brooks College of Health
Degree Name
Doctor of Clinical Nutrition (DCN)
Department
Nutrition & Dietetics
NACO controlled Corporate Body
University of North Florida. Department of Nutrition & Dietetics
Committee Chairperson
Dr. Andrea Arikawa
Second Advisor
Dr. Lauri Wright
Third Advisor
Dr. Julia Fayez Massaad
Department Chair
Dr. Andrea Arikawa
College Dean
Dr. Jen Ross
Abstract
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by inflammation, visceral hypersensitivity, altered gut microbiota, and dysmotility, leading to significant healthcare costs and patient burden. Despite dietary interventions being a primary therapeutic strategy, many IBS patients receive only basic low FODMAP diet guidance from non-dietitian providers, resulting in inconsistent adherence to evidence-based recommendations. This prospective, quasi-experimental study examined the impact of dietitian-led low FODMAP nutrition therapy on IBS symptom severity (IBS Symptoms Severity Score, IBS SSS) and quality of life (QOL) indicators, including stress, sleep, and physical activity. The study was conducted at Emory Digestive Health Ambulatory Clinics from September 2023 to June 2024, enrolling IBS-diagnosed patients referred by gastroenterologists using ROME criteria. Exclusion criteria included Crohn’s disease, gastroparesis, diabetes on metformin, celiac disease, and eating disorders. Participants received two nutrition counselling sessions, including an elimination phase (4–6 weeks) followed by food reintroduction.
Forty-four patients participated, with four dropouts. The sample comprised predominantly Caucasian women (85%) with an average age of 54 years. Notably, only 10% had previously consulted a dietitian, and 15% reported no prior dietary modifications. Statistical analysis using the Wilcoxon Signed-Rank test revealed significant reductions in general abdominal pain (p = .002), abdominal pain in the past 10 days (p < .001), abdominal distention (p < .001), satisfaction with bowel habits (p < .001), and impact on daily life (p < .001). Medication use decreased post-intervention. No significant differences were found across IBS subtypes (p = .282). However, physical activity negatively correlated with IBS SSS change, suggesting symptom improvement facilitated greater participation. Reported adherence challenges included restrictive diet requirements, travel difficulties, and financial burden.
The study highlights the effectiveness of dietitian-led FODMAP interventions in reducing IBS symptoms and improving daily functioning. Findings emphasize the need for interdisciplinary collaboration, physician referrals to dietitians, expanded FODMAP diet training, and Medicare coverage for nutrition counselling in IBS management.
Suggested Citation
Sharma, Anju, "Dietitian led low FODMAP nutrition intervention improves gastrointestinal symptoms in irritable bowel syndrome patients at Emory Digestive Health Clinic" (2025). UNF Graduate Theses and Dissertations. 1321.
https://digitalcommons.unf.edu/etd/1321