Medical Nutrition Therapy For Gastrointestinal Disorders

  • Saasha GovenderDiplomas in Journalism, Human Nutrition, and Effective Writing
  • Duyen NguyenMaster in Science - MSci Human Biology, University of Birmingham
  • Regina LopesSenior Nursing Assistant, Health and Social Care, The Open University

Poor diet and nutrition are becoming two major risk factors for developing or worsening different health conditions. Lawrence Haddad, the executive director of the Global Alliance For Improved Nutrition, confirms this, saying: 

"If you look at all the diet-related risk factors for health, they outweigh the burden of all the other risk factors combined."

This has triggered a growing interest in therapy through food. Medical Nutrition Therapy, or MNT, as it is more commonly known, is a therapeutic approach used to manage or treat medical conditions and their symptoms, putting medical nutrition therapy at the forefront of health and wellness.

It's based on a person's nutritional status and can vary from one person to another. Some MNTs involve specific diets and lifestyle changes, while others have more advanced nutrition interventions, such as intravenous or tube feeding.

Let's look at medical nutrition therapy for gastrointestinal disorders in more detail below. 

Understanding gastrointestinal disorders and medical nutrition therapy

Before we dive into the intricacies of medical nutritional therapy (MNT), we need to understand one of the conditions it's used to treat. 

Gastrointestinal disorders (GI disorders) are health conditions that affect the entire digestive tract. This extends from the mouth to the anus. It includes organs like oesophagus, stomach, small intestine, large intestine (colon), and rectum. 

Some of the most common GI disorders include:

These disorders share similar symptoms that can affect your daily life. Symptoms range in intensity and include pain or discomfort in the abdominal region, changes in bowel habits, and nausea. The frequency of the symptoms can vary and range in intensity. 

While medications may offer temporary relief for them, they aren't a convenient or long-term solution. On the other hand, MNT is a more sustainable and comprehensive approach.

The term was first introduced to the medical world in 1994 by The Academy of Nutrition and Dietetics. The evidence-based, individualised nutrition process effectively manages and treats certain conditions such as GI disorders. 

MNT involves a mix and match of dietary changes centred around the specific GI disorder you’re suffering from, paired with your dietary preferences and needs. Unlike medication-focused approaches, MNT encourages you to actively participate in your digestive health, enforcing informed dietary choices for long-term benefits. 

The details behind medical nutritional therapy

Despite popular belief, MNT is not nutrition education. The difference lies in the type of information provided and its intended use. Nutrition education is basic information given to the general public. It isn't intended to treat a specific condition where as MNT is. MNT tells us how to use our diets to manage medical conditions. It doesn’t just address existing medical issues but also lowers the risk of new complications.

MNT programmes are based on decades of medical research that explains the relationship between diet, nutrition, and health outcomes. They are implemented by a registered dietitian nutritionist (RDN) with your doctor's approval. 

The diet plan can be conducted in an outpatient clinic, hospital, or as part of a telehealth program. If you have a GI disorder, your MNT will start with a comprehensive nutrition assessment and diagnosis. This is done to pave a clear path to your end goal — manage current symptoms and prevent their reoccurrence. MNT plans can range in complexity, depending on the type of GI disorder being treated and the severity of your symptoms. 

The duration of the therapy will vary as well. Typically, it stays in place until the initial goal is achieved. As time goes by and symptoms change, an RDN might alter the details of your plan to suit your progress. The RDN will provide repeated follow-up visits to ensure you are on track with behavioural and lifestyle changes.

Medical nutrition therapy plans 

Creating detailed MNT plans for specific GI disorders requires a comprehensive understanding of the condition itself and the symptoms you are experiencing.

Although each plan is unique, there are some broad guidelines and dietary requirements that are recommended for specific conditions. Below are recommendations for 5 common GI disorders.

Gallstones

  • Low-fat diet: Emphasise a low-fat diet to reduce gallbladder stimulation and decrease the risk of gallstone formation
  • High-fibre foods: Include fibre-rich foods to support digestive health and maintain a healthy weight
  • Hydration: Ensure adequate fluid intake to prevent dehydration and promote overall well-being

Peptic ulcers

  • Moderate diet: Adopt a balanced diet, avoiding extremes in temperature and spicy or acidic foods to minimise irritation
  • Frequent, small meals: Opt for smaller, more frequent meals to reduce stomach acid production and prevent discomfort
  • Limit caffeine and alcohol: Reduce intake of known irritants to the stomach lining (e.g., caffeine and alcohol)

Irritable Bowel Syndrome (IBS):

  • Low-FODMAP diet: Follow a low-FODMAP diet to manage symptoms by reducing fermentable carbohydrates
  • Probiotics: Incorporate probiotics to support gut health and alleviate symptoms
  • Hydration: Ensure adequate water intake to prevent constipation or diarrhoea

Gastroesophageal Reflux Disease (GERD):

  • Low-acid diet: Adopt a low-acid diet, minimising acidic foods and beverages
  • Lean proteins: Choose lean protein sources to avoid excessive fat intake, which can worsen symptoms
  • Elevate head during sleep: Prop up the head of the bed to reduce nighttime reflux

Inflammatory Bowel Disease (IBD - Crohn's Disease and Ulcerative Colitis):

  • Low-residue diet during flares: Reduce fibre intake to ease bowel irritation during flare-ups
  • Protein-rich diet: Include lean proteins to support tissue repair
  • Calcium and vitamin D: Monitor and supplement these nutrients as IBD medications may impact absorption
  • Hydration and electrolytes: Pay attention to fluid and electrolyte balance, especially during diarrhoea episodes

What studies say about MNT

Although there is limited research to support the use of MNT, some studies have provided evidence for its effectiveness. For example, a 2020 study investigated the impact of diet and nutrients on gastrointestinal chronic diseases.1 The findings reported that MNT can significantly affect GI symptom management and treatment. The individualised approach effectively managed symptoms of IBS, IBD, and GERD.

The research study also reports a noticeable link between the "Westernised diet" (which involves a high consumption of animal fats and refined sugars) and the worsening of symptoms of gastrointestinal diseases. 

So, the first thing MNT does for GI disorders is control the intake of such foods. Diets like low-FODMAP and Crohn's disease exclusion diet (CDED) show promise in managing common GI disorders. Below, we look at a few primary types of foods explained in these diets.

Low-FODMAP

This refers to a diet that restricts fermentable carbohydrates known as FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols).2 It is often used to manage irritable bowel syndrome (IBS) symptoms and other digestive disorders.

CDED

The Crohn's Disease Exclusion Diet is a dietary approach that excludes certain food groups. This includes specific carbohydrates and processed foods that trigger symptoms of Crohn's disease. The CDED is designed to reduce inflammation and support overall gut health.

The 2023 study also evaluated results from several other studies, all supporting MNT for GI disorders. The evidence showed that well-thought-out dietary choices can improve conditions and reduce symptoms.3

Despite these positive findings, there is a recognised need for more extensive and detailed research. Researchers aim to delve deeper into the most effective dietary approaches for each specific gastrointestinal disease, considering factors like long-term adherence and overall patient health.

Diets for gastrointestinal disorders

If you have a GI disorder and are still weighing in on whether MNT is for you. You can make simple changes to help you set a foundation for therapy intervention. Some of the changes include:

  • Always opt for whole grains
  • Adding more probiotics to your diet
  • Reduce your intake of added sugars and animal fats
  • Limit your consumption of meat and processed meats
  • Try healthier food preparation methods like steaming, boiling, and grilling rather than deep frying
  • Incorporate fruits and vegetables into your diet. The aim is to eat five to seven servings of fruits and vegetables daily

You can also follow other diets like the Mediterranean diet, 4 the Paleo diet, and the specific carbohydrate diet.5

Summary

Poor diet poses a huge health risk as it not only worsens existing conditions but can also make you more susceptible to developing additional health problems. Medical nutrition therapy (MNT) emerges as a solution to improve your overall health and help manage your symptoms, it is especially beneficial for gastrointestinal (GI) disorders.

This type of therapy is a promising treatment for improving health conditions and overall well-being through informed nutritional choices. MNT tailors dietary changes to specific conditions, actively involving individuals for long-term benefits. Multiple research studies have provided evidence for MNT's success in managing GI issues, indicating that simple dietary changes can set the foundation for improved prognosis and treatment success. 

References

  1. Corsello A, Pugliese D, Gasbarrini A, Armuzzi A. Diet and nutrients in gastrointestinal chronic diseases. Nutrients [Internet]. 2020 Sep 3 [cited 2024 Jan 26];12(9):2693. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551310/
  2. Low fodmap diet: medlineplus medical encyclopedia [Internet]. [cited 2024 Jan 26]. Available from: https://medlineplus.gov/ency/patientinstructions/000984.htm
  3. Fliss-Isakov N, Aviv Cohen N, Bromberg A, Elbert G, Anbar R, Ron Y, et al. Crohn’s disease exclusion diet for the treatment of crohn’s disease: real-world experience from a tertiary center. J Clin Med [Internet]. 2023 Aug 21 [cited 2024 Jan 26];12(16):5428. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455757/
  4. Nagpal R, Shively CA, Register TC, Craft S, Yadav H. Gut microbiome-Mediterranean diet interactions in improving host health. F1000Res [Internet]. 2019 May 21 [cited 2024 Jan 26];8:699. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/
  5. Suskind DL, Lee D, Kim YM, Wahbeh G, Singh N, Braly K, et al. The specific carbohydrate diet and diet modification as induction therapy for pediatric crohn’s disease: a randomized diet controlled trial. Nutrients [Internet]. 2020 Dec 6 [cited 2024 Jan 26];12(12):3749. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762109/
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Saasha Govender

Diplomas in Journalism, Human Nutrition, and Effective Writing

I am a seasoned health writer with extensive experience in the medical field spanning over several years. My expertise is a fusion of investigative prowess and an unwavering passion for all facets of healthcare. Holding diplomas in Journalism, Human Nutrition, and Effective Writing, along with certification and practical experience in Ancillary Healthcare and Telehealt —I possess a solid foundation that enables me to navigate the scientific intricacies of medical/health-related topics.

My approach goes beyond the surface, as I aim to translate complex theories into reader friendly information without sacrificing medical stance. This ensures readers gain accurate knowledge that can drive change toward improving their health.

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