Physician and Patient Education on Diet and the Gut
On May 29, 2016, the American College of Gastroenterology will focus on Diet and the Gut in observance of World Digestive Health Day, a global awareness day sponsored by the World Gastroenterology Organisation. WGO seeks to raise awareness of the relationship between what we eat and gastrointestinal symptoms through its annual public advocacy and awareness day. WGO wants to ensure that patients receive appropriate dietary and lifestyle advice as well as appropriate investigations and treatment for different gastrointestinal conditions where diet may play a role.
ACG Resources on Diet and the Gut: Watch. Listen. Read.
The College has identified a number of physician and patient education resources that dovetail with WGO’s spotlight on diet and the gut. Video presentations from the ACG Annual Scientific Meeting, featured lectures, podcasts with experts, and articles from The American Journal of Gastroenterology are among the ways you can learn more. ACG hopes you enjoy exploring these materials featured in honor of World Digestive Health Day.
Diet and Irritable Bowel Syndrome
- “Intestinal Microbiota And Diet in IBS: Causes, Consequences, or Epiphenomena?” Rajilic-Stojanovic, et al., The American Journal of Gastroenterology 2015, open access article.
- “Food for Thought,” by Sarah DeWeerdt from Nature Outlook, (May 2016) open access article.
Many people with irritable bowel syndrome feel that they benefit from dietary interventions, but researchers still lack a full understanding of how food can inflame this disorder.
- “Diet: Which Should You Choose for Your IBS Patient?” William D. Chey, MD, FACG, Video presentation from ACG 2015 Annual Scientific Meeting.
- “Food: The Main Course to Wellness and Illness in Patients with IBS,” William D. Chey, MD, FACG, AJG Author Podcast.
Dr. Chey addresses the evolution of food from sustenance and medicine to entertainment and enjoyment and the gradual shift back toward food as medicine and therapy for disease. Learn more about the complex interplay between food and GI symptoms and the FODMAP diet as a promising treatment approach. The emerging academic focus on diet and nutrition in GI care and the essential role of dietitians in the lives of IBS patients are also discussed.
- “Differential Effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on Small and Large Intestinal Contents in Healthy Subjects Shown by MRI,” Robin C. Spiller, MD, FRCP, AJG Author Podcast.
Dr. Spiller, co-author of research on the effect of FODMAPs such as fructose and fructans on irritable bowel syndrome (IBS) symptoms published in the January 2014 issue of AJG, talks with former AJG Co-Editor Dr. William Chey about the dietary substances included in the FODMAP classification, the MRI imaging techniques used to measure FODMAP impact on colonic distention and gas production in this study, and how clinicians might consider FODMAPs along with gluten and lactose when recommending dietary interventions for IBS patients.
- “Differential Effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on Small and Large Intestinal Contents in Healthy Subjects Shown by MRI,” Kathryn Miller et al. The American Journal of Gastroenterology 2014, open access article.
- “Food Choice as a Key Management Strategy for Functional Gut Symptoms,” AJG Author Podcast with Professor Peter Gibson (May 2012).Professor Peter Gibson reviews the quality of the evidence on diets high or low in poorly absorbed short-chain carbohydrates, known as FODMAPs (Fermentable Oligo-, Di- and Mono-saccharides and Polyols) and their impact on functional gastrointestinal symptoms. In a discussion with former AJG Co-Editor Dr. William Chey, Professor Gibson provides insights on implementing dietary approaches in the office and discusses the challenges of recognizing patients with non-celiac gluten sensitivity.
- “What I need to know about Lactose Intolerance,” National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK).
- ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease (2013).
- “Celiac Disease versus Gluten Intolerance or Sensitivity,” Sheila E. Crowe, MD, FACG, ACG Best Practices Course (January 2016).
Celiac Podcasts with AJG Authors
- “Non-Celiac Gluten Sensitivity: Distinct Clinical Condition?” AJG Podcast with William D. Chey, MD, FACG, and Joseph A. Murray, MD (December 2012).Recent research by Antonio Carroccio, MD, that suggests the existence of non-celiac wheat sensitivity as a distinct clinical condition is the basis for a discussion between AJG Co-Editor William D. Chey, MD, FACG, and Joseph A. Murray, MD, who is lead author of an upcoming clinical management guideline for celiac disease that will be published in the Red Journal. Dr. Murray helps define non-celiac gluten sensitivity, explores why gluten-free diets are unsatisfactory as a diagnostic tool, and explains the need for scientific advancement in this area. Dr. Carroccio’s paper was published in the December issue of The American Journal of Gastroenterology.
- “ACG Practice Guidelines on the Diagnosis and Management of Celiac Disease,” AJG Author Podcast with Joseph A. Murray, MD, FACG, and Ciarán P. Kelly, MD, FACG (2013).Joseph A. Murray, MD, FACG, and Ciarán P. Kelly, MD, FACG, co-authors of the American College of Gastroenterology’s new Clinical Guideline on the Diagnosis and Management of Celiac Disease, talk with former AJG Co-Editor William D. Chey, MD, FACG, about the key components of the guidelines, including the working definition of celiac disease, screening techniques such as small bowel biopsy and genetic testing, best practices for gluten challenge, as well as routine celiac patient monitoring and emerging treatments.
- “Novel Role of the Serine Protease Inhibitor Elafin in Gluten-Related Disorders,” AJG Podcast with Elena F. Verdu, MD, PhD (May 2014).Elena F. Verdu, MD, PhD, co-author of new research on the role of the serine protease inhibitor elafin in celiac disease published in the May 2014 issue of AJG, talks with AJG Co-Editor Dr. William D. Chey about the pathophysiology of celiac disease, the role of various serine proteases, including elafin, in the inflammatory processes of celiac disease, and the potential diagnostic and treatment implications of the study findings.
- “Gluten Avoidance in Non-Celiac Patients,” AJG Author Podcast with Joseph A. Murray, MD (March 2015).Joseph A. Murray, MD, co-author of a recent article on the racial/ethnic trends in celiac disease and gluten-free diets, talks with AJG Co-Editor Dr. William Chey about the racial differences in the prevalence of celiac disease, the startling increase in this prevalence over the last 20 years, and how physicians should consider celiac disease in the context of related disorders for at-risk populations. Dr. Murray also discusses the puzzling recent trend of non-celiac patients adhering to a gluten-free diet for “health” reasons not supported by science.
ACG Celiac Information for Patients
National Institutes of Health (NIH) Celiac Disease Awareness Campaign
- General Consumer Information about Food Allergy from the National Institutes of Health, National Institute for Allergy and Infectious Diseases (NIAID)
- “Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel” (2010).According to the National Institutes of Health, “Food allergy is an immune-based disease that has become a serious health concern in the United States. A recent study estimates that food allergy affects 5% of children under the age of 5 years and 4% of teens and adults, and its prevalence appears to be on the increase.” In 2010, the National Institute of Allergy and Infectious Diseases developed guidelines to establish consensus and consistency in definitions, diagnostic criteria, and management practices for food allergies.
- NIAID Food Allergy Guidelines Summary for Clinicians (2010).
- NIAID Food Allergy Guidelines Summary for Families, Caregivers (2010).
Learn More About FODMAPs
- “When Everyday Foods Are Hard to Digest, GI Specialists Suspect Specific Carbohydrates May Cause Painful Symptoms of Irritable Bowel Syndrome,” Wall Street Journal (November 8, 2011) mention of science presented at ACG Annual Scientific Meeting.
- University of Michigan, “My GI Nutrition,” Low FODMAP Diet resources for patients.
- Monash University, Australia, “Low FODMAP Diet for Irritable Bowel Syndrome.”
Gut Microbiota for Health – a coalition led by the European Society of Neurogastroenterology & Motility
According to Gut Microbiota for Health, “In the past decade, one of the main factors responsible for the breakthroughs in understanding how diet affects gut health has been knowledge about the human gut microbiota. Researchers have uncovered relationships between diet and gut microbiota, and in turn, between gut microbiota and health. Although many of the details are not yet clear, the research to date provides compelling evidence that the role of diet in a patient’s overall health cannot be ignored.”