Don’t shoot the messenger
Reference:
GI Docs Nutrition Education Deficit May Shortchange Patients
Jennifer Lubell. Medscape Medical News, October 23, 2023
Yevgenia Pashinsky, MD, has seen her share of patients who have bounced from one gastroenterologist to the next after becoming frustrated when food elimination, supplements, or medications don’t alleviate their gastrointestinal (GI) symptoms.
In most cases, their decision to switch gastroenterologists comes down to a simple fact: No one dissected their diets.
The situation underscores how essential it is for gastroenterologists to be comfortable with nutrition concepts, said Pashinsky, a gastroenterologist with New York Gastroenterology Associates (NYGA) and affiliated with Mount Sinai Hospital in New York, NY.
“There should be a focus in recognizing patterns that will help the physician pinpoint triggers, thereby helping identify the underlying disorder and guide further diagnostic and treatment options,” she said.
Although many common digestive diseases and their corresponding outcomes are linked to dietary quality and are complicated by poor nutrition and/or obesity, nutrition often gets pushed to the wayside in GI education, write Carolyn Newberry, MD, Brandon Sprung, MD, and Octavia Pickett-Blakely, MD, MHS, in a recent analysis.
“Gastroenterology fellows report limited exposure to nutrition topics leading to knowledge deficit on assessment,” they add.
As a result, not enough gastroenterologists are giving this topic the attention it needs, some in the industry contend.
One 2022 study based on a survey of 279 GI clinicians treating patients with irritable bowel syndrome (IBS) reported that only 56% felt that they were trained to provide nutrition education, and 46% said that they sometimes, rarely, or never offered to help patients with their menu planning, label reading, or grocery shopping. And 77% said that they spent 10 minutes or less counseling patients on nutrition. Though almost all respondents (91%) said that having access to a dietitian would help them better manage patients with IBS, 42% said that they lack access to one.
But some gastroenterology professors are working to incorporate nutrition into GI training and integrating dietitians in their work with fellows as well as collaborating with dietitians to improve care in their own practices.
