Evidence for change

Improving outcomes for IBS and associated conditions

The prevalence of irritable bowel syndrome (IBS) in the UK is estimated to be between15% and 20% (King’s, 2014), so therefore affects ~1 in 5 people at some stage of their lives. Therefore, in Wales it is likely that around 450,000 people suffer with IBS.

Symptoms of IBS are very individual, but are characterised by bloating, abdominal cramps and pain, excessive wind, diarrhoea with ‘urgency’ and constipation. IBS is often described as a functional gut disorder and often involves invasive investigations to reach a diagnosis. It has traditionally been treated with medication, but drug treatment can often add to the problem.

Sufferers often try independent dietary manipulation, increasing the risk dietary imbalance and deficiencies or are signposted to often unreliable online dietary advice.

The traditional approach to dietary management has concentrated on regularity of meals, adjustments to fibre intake and reductions of caffeine, fatty and spicy foods. For a minority of patients with a poor dietary intake and an irregular meal pattern, this advice may be sufficient, but for most this has little effect on their debilitating symptoms.

The scientific evidence states that FODMAP trained dietitians are essential part of the service for people with IBS and related symptoms. Early access to professional support can also help identify people with coeliac disease, inflammatory bowel disease and colorectal cancer earlier with multidisciplinary working across dietetics, gastroenterology and primary care.

The evidence and the guidelines are clear on the impact that can be made with the right access to specialist care.

Some of the recent publications on the role of dietitians in primary care highlight the opportunities. This includes reducing workload for GPs, and support patients such as self-management including for people with long term conditions and food related ill-health (BDA, 2017). The impact on health service utilisation was followed as part of a service evaluation of a dietetic‐led IBS clinic, and this showed that on a one year follow up, patients were reporting improved symptoms with a substantial decrease in any patient visit to GPs and for specialist gastroenterologist services, and a slight reduction in medication usage for gut symptoms (read online). These are results being published in 2021 as well as over the last 6 years.

Patient feedback and measurement taken for the adoption sites in Wales are showing positive benefits and echoing the results from the available evidence.

Find out more about the results from the adoption sites.

This is what Tricia (from Swansea) who joined the programme had to say about her sessions with as part of a dietitian-led service.

She reflected on how her approach to what food to avoid (as they would have triggered her IBS symptoms) had turned out not to be correct.
“You think you’ve been doing it right – but I’ve been doing it wrong. I wish I’d known about this diet 10 years ago. I still have some slight blips but I know how to deal with them now. It has been amazing.”

Her life had been affected by her gut symptoms and this is very common for people with IBS or food-related symptoms.
“You don’t really go out and eat things because you’re constantly looking for where the toilet is. It’s just life-changing.“
And following her treatment, her quality of life has improved.
“Now I go out, I know what I can eat and what I can’t eat so I’m not putting myself in a position to make me unwell.