Virtual Dietitian Consults for Irritable Bowel Syndrome

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Nova Scotia Health Authority

Disqualifiers: Inflammatory bowel disease, Rectal bleeding, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 12 weeks

76 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It focuses on dietary changes for managing IBS.

What data supports the effectiveness of the treatment Virtual Dietary Education for Irritable Bowel Syndrome?

Research suggests that dietary changes are important for managing IBS, and digital methods like webinars can effectively deliver dietary education to patients, making it a feasible and cost-efficient approach. ^{1 2 3 4 5}

Is it safe to use virtual dietitian consults for managing irritable bowel syndrome?

The research does not provide specific safety data for virtual dietitian consults, but these services are generally considered safe as they involve dietary advice and education, which are non-invasive and low-risk. ^{1 2 3 4 6}

How is the Virtual Dietary Education treatment for IBS different from other treatments?

Virtual Dietary Education for IBS is unique because it uses digital technology, like webinars, to provide dietary advice and education remotely, making it more accessible and potentially more cost-efficient compared to traditional in-person dietitian consultations. ^{1 3 4 6 7}

What is the purpose of this trial?

Irritable bowel syndrome is a functional bowel disorder that affects many Canadians. The syndrome involves abdominal pain and change in frequency or form of bowel movements, and these symptoms can lead to a decreased quality of life for patients. Primary care physicians are dissatisfied with current referral processes, and patients may wait a long time to receive the correct diagnosis. Diet is known to exacerbate symptoms of IBS. In Canada, accessing dietary treatment for IBS is a challenge due to lack of resources. Some patients lack access to dietary interventions, and others are given advice that is not evidenced based. Use of eHealth technology, such as virtual education delivered by a dietician, may allow for more widespread access to dietary interventions for IBS. Virtual education can include one on one dietary education, online group-based education, and the use of apps. Currently, there is a gap in knowledge whether dietary intervention for IBS, delivered virtually by a dietician, is effective in treating IBS.

Eligibility Criteria

This trial is for individuals with Irritable Bowel Syndrome (IBS) who have regular abdominal pain and changes in bowel habits. Participants need to have access to a device for virtual dietary education and be willing to change their diet.

Inclusion Criteria

You can access a device to attend online nutrition classes.

I have had stomach pain at least once a week for the last 3 months, which changes with my bowel movements.

You are okay with changing your diet.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive virtual dietary education through either one-on-one consults with a dietitian or an online group education program

12 weeks

1 initial visit (virtual, 60 minutes) + 4 follow-up visits (virtual, 30 minutes each) for one-on-one consults; biweekly group calls (virtual, 45 minutes each) for group program

Follow-up

Participants are monitored for effectiveness of dietary interventions and quality of life improvements

5 months

Treatment Details

Interventions

• Virtual Dietary Education

Trial Overview The study tests if IBS symptoms can be improved through virtual dietary education provided by dietitians. This includes one-on-one consultations, online group sessions, and possibly app-based support.

Participant Groups

Group I: virtual dietitian consults for IBS patients Experimental Treatment 1 Intervention

This arm will receive consults with a virtual dietitian (60 minutes initial + 4 x30-minute follow-up appointment) by a dietitian who has had additional training in the dietary management of IBS.

Group II: pre-existing online group education program for IBS Active Control 1 Intervention

This arm will be enrolled in the online course run by Happy Bellies Nutrition https://www.happybelliesnutrition.com/ibs-gentle-group-program. The Happy Bellies nutrition course has 5.5 hours of total video content and optional biweekly group calls via Zoom (45-minutes per session). This course is designed to take 12 weeks to complete. The participants would have access to the content for one year.

Who Is Running the Clinical Trial?

Nova Scotia Health Authority

Lead Sponsor

Trials

302

Recruited

95,300+

Research Nova Scotia

Collaborator

Trials

3

Recruited

600+

Findings from Research

The study highlights that diet is crucial for managing irritable bowel syndrome (IBS), and many patients turn to the Internet for dietary advice.

However, the research found that online dietary recommendations for IBS often lack quality and accuracy, which can mislead patients seeking reliable information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of Quality and Readability of Internet Dietary Information on Irritable Bowel Syndrome. Alfaro-Cruz, L., Kaul, I., Zhang, Y., et al.[2020]

A survey of 1,562 gastroenterologists revealed that nearly 60% believe patients with irritable bowel syndrome (IBS) often link food to their gastrointestinal symptoms, and most recommend dietary therapy, particularly a low FODMAP diet.

Despite the enthusiasm for dietary treatments, only 21% of gastroenterologists regularly refer IBS patients to registered dietitians, indicating a gap in nutritional counseling for effective management of IBS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of Dietary Management in Irritable Bowel Syndrome: Results of a Survey of Over 1500 United States Gastroenterologists. Lenhart, A., Ferch, C., Shaw, M., et al.[2022]

The guidelines for managing Irritable Bowel Syndrome (IBS) emphasize a structured dietary approach, starting with clinical assessments and general healthy eating advice, followed by advanced interventions like probiotics and specific carbohydrate management.

A total of 30 studies were reviewed to create these evidence-based guidelines, highlighting the importance of tailored dietary strategies and the need for further research through well-designed clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults. McKenzie, YA., Alder, A., Anderson, W., et al.[2022]

A study involving 1171 attendees showed that webinars for IBS education significantly improved patients' knowledge (from 25% to 67% reporting excellent or good knowledge) and confidence in managing their condition (74% reported improved confidence).

The implementation of these webinars resulted in a 44% reduction in referrals for one-on-one dietitian appointments, saving an estimated £3593 in clinical time costs annually, making it a cost-effective solution for patient education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility, acceptability and cost efficiency of using webinars to deliver first-line patient education for people with Irritable Bowel Syndrome as part of a dietetic-led gastroenterology service in primary care. Williams, M., Barclay, Y., Harper, L., et al.[2021]

A survey of 1,242 IBS patients revealed that many hold misconceptions about the condition, such as believing it is caused by a lack of digestive enzymes or that it can develop into cancer, indicating a significant need for better patient education.

Patients expressed a strong interest in learning about dietary changes, causes of IBS, and coping strategies, highlighting the importance of targeted educational resources, especially for those who seek information online.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What patients know about irritable bowel syndrome (IBS) and what they would like to know. National Survey on Patient Educational Needs in IBS and development and validation of the Patient Educational Needs Questionnaire (PEQ). Halpert, A., Dalton, CB., Palsson, O., et al.[2022]

A survey of 279 gastroenterology providers revealed that while 56% feel trained to provide nutrition education for IBS, nearly half do not offer practical dietary guidance, indicating a significant gap in patient care.

Despite the majority (91%) agreeing that access to a GI dietitian would enhance IBS management, 42% of providers reported lacking access to such specialists, highlighting a barrier to effective treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Utilization of Dietitians in the Management of Irritable Bowel Syndrome by Members of the American College of Gastroenterology. Scarlata, K., Eswaran, S., Baker, JR., et al.[2022]

In a large French cohort study of 41,682 participants, a stable vegetarian diet (VD) was found to be associated with an increased risk of irritable bowel syndrome (IBS) and its subtypes, particularly IBS mixed and IBS diarrhea.

While the overall analysis did not show a significant association between VD and IBS, those who adhered to a vegetarian diet consistently reported higher odds of developing IBS, suggesting that long-term dietary patterns may influence gastrointestinal health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between self-reported vegetarian diet and the irritable bowel syndrome in the French NutriNet cohort. Buscail, C., Sabate, JM., Bouchoucha, M., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Assessment of Quality and Readability of Internet Dietary Information on Irritable Bowel Syndrome. [2020]

2. Korea (South) pubmed.ncbi.nlm.nih.gov

Use of Dietary Management in Irritable Bowel Syndrome: Results of a Survey of Over 1500 United States Gastroenterologists. [2022]

3. England pubmed.ncbi.nlm.nih.gov

British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Feasibility, acceptability and cost efficiency of using webinars to deliver first-line patient education for people with Irritable Bowel Syndrome as part of a dietetic-led gastroenterology service in primary care. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

What patients know about irritable bowel syndrome (IBS) and what they would like to know. National Survey on Patient Educational Needs in IBS and development and validation of the Patient Educational Needs Questionnaire (PEQ). [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Utilization of Dietitians in the Management of Irritable Bowel Syndrome by Members of the American College of Gastroenterology. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Association between self-reported vegetarian diet and the irritable bowel syndrome in the French NutriNet cohort. [2018]