Defining the role of the IBD Dietitian
Julie Vanderstappen, D-ECCO Member
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As a D-ECCO Committee Member, it is my mission, along with my fellow D-ECCO’ers, to educate and train other dietitians and healthcare professionals in the field of IBD. Also, with dietary therapies and beliefs still growing and consolidating their place in the prevention and treatment of IBD, there is an emerging need for skilled dietitians to guide our patients in the different nutritional pathways throughout their disease. But what makes a dietitian skilled in the field of IBD?
Historically, dietitians played only a minor role in the multidisciplinary approach to IBD. In most instances, they received a request for nutritional advice on food-related complications, such as malnutrition, obstruction or gastrointestinal discomfort, that were due to active disease [1]. However, as the evidence regarding the association between specific nutrients and dietary components and the prevention and/or treatment of IBD grew, the registered dietitian became an undeniably needed member of the multidisciplinary IBD team.
Nowadays IBD Dietitians play a crucial role in the fundamentals of dietetics, such as performing nutritional assessments or educating patients on the basics of nutrition in IBD, but they also need to educate themselves or to be educated in order to ensure that the nutritional advice they are providing is evidence based and up to date. As the number of publications favouring nutritional support for patients has increased in number, the role of IBD Dietitians has extended to span the entire disease course. Thus, it now ranges from recommending nutrition for prevention, treatment and remission to preoperative optimisation and the management of nutritional deficiencies and restrictive eating patterns.
But the role of the IBD-specialized dietitian within the multidisciplinary team is not limited to expanding knowledge on appropriate clinical practice. Recent publications on the prevention and management of food avoidance in IBD [2] and on the impacts of food on quality of life and disease [3] show that there are still more roles to discover for the IBD-specialized dietitian. So now is an appropriate time to further define what being an IBD Dietitian actually entails so that we can keep improving our work as dietitians within IBD multidisciplinary teams.
D-ECCO’s aim is not only to educate but also to help and support all dietitians and other healthcare professionals who would like to specialize in IBD and to create a platform that makes this possible . Therefore, we are looking forward to the first ECCO Consensus on diet and nutrition in IBD, which will acquaint the IBD Community with the currently available evidence and offer practical guidance. In the meantime, many items waiting to be discovered on the D-ECCO Webpage illustrate the diversity of the role of the IBD Dietitian and indicate that there is still a lot to learn. Examples include e-courses on exclusive enteral nutrition in Crohn’s Disease and multidisciplinary perinatal care in IBD and a talking heads debate on the current knowledge of treatment in Crohn’s Disease.
References
- Fitzpatrick JA, Melton SL, Yao CK, Gibson PR, Halmos EP. Dietary management of adults with IBD – the emerging role of dietary therapy. Nat Rev Gastroenterol Hepatol 2022;19:652–69.
- Godny L, Dotan I. Avoiding food avoidance in patients with inflammatory bowel disease. United European Gastroenterol J. 2023; 11:321–3.
- Whelan K, Murrells T, Morgan M, et al. Food-related quality of life is impaired in inflammatory bowel disease and associated with reduced intake of key nutrients. Am J Clin Nutr 2021;113:832–44.