Resources Nutrition GI Part 1- Chronic gastrointestinal conditions
GI Assessment/IBS/Psychogastroenterology/Low FODMAP diet/Coeliac disease/Gut microbiota/SIBO
Dietitians are firmly established as specialists of gastrointestinal concerns.
The breadth and depth of working knowledge needed to address GI concerns is considerable. Often we are acting as a clinicial co-ordinator; interpreting symptom progression, flagging further testing, addressing nutritional adequacy, supporting plan adherence and addressing psychosocial issues.
It can get complicated quickly.
We’ve been challenged to avoid simplistic practices. Rather our profession is developing skills towards highly personalised and comprehensive approaches. We are learning to ask meaningful questions and to listen for meaning in the answers.
Our presentations on gastrointestinal nutrition reflect the extent of clinical skill needed to work proficiently with our GI clients.
Below is a list of our presentations for Part 1: IBS/FODMAP/Coeliac disease/SIBO/gut microbiota. We have a separate list for Part 2: IBD/anatomical and acute GI conditions
Gastrointestinal assessment
Assessing your GI client. Part 1: Collecting initial data
Marnie Nitschke, APD
- Establishing trust and rapport
- Collecting and interpreting clinical data
- The referral
- Relevant history and medications
- Interpreting investigations, results
Read a review of the presentation here
Assessing your GI client. Part 2: Interpretation and diet management
Marnie Nitschke, APD
- Interpreting GI signs and symptoms (clues, red flags)
- Diet history – qualitative, quantitative and behavioural factors
- Forming a nutritional assessment
- Creating a clear management plan to set you and your client up for success
Read a review of the presentation here
Irritable bowel syndrome
Approaches to management of IBS
Joanna Baker, APD & RN
- Diagnosis of IBS
- Non-Food conditions which may cause IBS type symptoms
- Parasitic infections
- Inflammatory bowel diseases
- Small Intestinal Bacterial Overgrowth
- Bile acid diarrhoea
- Gastroparesis
- Endometriosis
- Gut - Brain Axis and visceral hypersensitivity
- FOOD sensitivities which may cause IBS symptoms
- Sucrase-Isomaltase deficiency
- Whole food intolerances
- FODMAPS
- Food Chemicals (salicylates, amines, glutamates)
Read a review of the presentation here
Step-by-step management of food sensitive IBS
Joan Breakey, APD & Ashleigh Jones, APD
The presentation describes a step-by-step guide to food sensitive IBS:
- Work with your patient to identify suspect foods
- Help your patient identify specific symptoms
- Take a history of their dietary management – what changes have they already made?
- First things first – key ideas to consider before embarking on an elimination diet
- The Diet Detective Approach – using the family sensitivity history to find food clues
- Designing your patient’s own elimination diet - tailored to their own unique needs
- Personalised challenges – food-focused challenges that work for your patient
- Your patient’s own best diet – completely individualised to your patient’s needs
Read a review of the presentation here
Food sensitive IBS: case studies
Joan Breakey, APD & Ashleigh Jones, APD
Joan and Ashleigh illustrate the diet detective approach in the management of food sensitivity in three clients with IBS.
- Amy, a 16 yr-old student with IBS brought in by her very concerned mother.
- Louisa, a 70-year-old woman who had a severe reaction to colonoscopy prep.
- James, a 45-year-old man who was certain that he was FODMAP-sensitive.
Read a review of the presentation here
Psychogastroenterology
Psychogastroenterology
Dr Jim Kantidakis, Gut-directed Psychologist & Clinical Hypnotherapist
- Introduction to the gut-brain axis
- Co-morbid psychological disorders
- Different psychological treatments for IBS and their effectiveness
- CBT
- Mindfulness
- Hypnotherapy
Read a review of the presentation here
The brain-gut axis
Dr Simon Knowles BA (Hons), MPsyc (Clinical), PhD, MAPS
- An explanation and description of the brain-gut axis
- The effect of stress, anxiety and depression on gastrointestinal conditions
- Psychological interventions for gastrointestinal disorders
Read a review of the presentation here
Low FODMAP diet
The Low FODMAP Diet in Practice
Joanna Baker, RN, APD
- Understanding FODMAPs and how they influence IBS
- Diagnosing patients suitable for the low FODMAP diet
- Implementing the Elimination phase
- Knowing how to challenge FODMAPs
Read a review of the presentation here
Teaching the Low FODMAP diet to your clients
Marnie Nitschke, APD
- Client assessment
- IBS and the Low FODMAP diet
- Eating low FODMAP:
- Planning meals
- Reading food labels
- Making recipes low FODMAP
- Eating out
- Keeping a food and symptom diary
- Challenges
- Reintroduction of foods
Read a review of the presentation here
Low FODMAP diet - 44-year-old woman: case study
Marnie Nitschke, APD
HC is a 44-year-old woman with IBS and lactose malabsorption. In this case study Marnie describes how she explains to HC what IBS is and the multitude of triggers which can be involved in IBS. She evaluates the breath test which HC has undergone and counsels HC on a Low FODMAP diet using a variety of Low FODMAP resources. Marnie describes in detail the results of HC’s FODMAP challenges and what the challenge results mean in terms of practical dietary advice.
Low FODMAP diet - 11-year-old boy: case study
Marnie Nitschke, APD
MW is an 11-year-old boy referred for “fructose malabsorption”. His Mother describes ‘tummy aches’ for at least a year. This has become more problematic in the last six months (mum often being called to pick MW up from sick bay, frequently missing school). In this case study Marnie illustrates how she explains what FODMAP foods are and what a Low FODMAP diet is. She identifies which foods may be causing MW symptoms and finds alternatives for these. Marnie describes the review appointments with MW, involving a FODMAP challenge schedule.
Coeliac disease
Teaching the gluten free diet. Two-part series
Sally Marchini, APD
Sally is an APD with both Type 1 Diabetes and Coeliac Disease, so she brings a wealth of personal and professional experience to this topic. Many dietitians have little practical knowledge of the gluten free diet and so are ill equipped to deal with coeliac clients. This two-part series will give you greater understanding and confidence in managing your coeliac clients.
Part 1 Gluten free diet essentials
- Client assessment
- Coeliac disease and the gluten free diet (including risks of not following it)
- Reading food labels
- Diet for the client to go home with suitable gluten free substitutes
- Maintaining CD professional competence
Read a review of the presentation here
Part 2 Gluten free diet practical details
- Eating out
- Nutritional adequacy of a GF diet
- Treating deficiencies with food and/or supplements
- Making recipes GF
- GF cooking on a budget
- Follow-up testing and screening of family members
- Ongoing symptoms
Read a review of the presentation here
Type 1 diabetes and coeliac disease
Sally Marchini, APD
- Prevalence of type 1 diabetes and coeliac disease
- Specific issues for people with type 1 diabetes and coeliac disease
- Everyday practical tips
- Resources and continuing care
Travelling gluten free
This 25-minute presentation is designed to use with clients.
Sally Marchini, APD
- Gluten-free classifications in other countries
- Making sure people understand you are gluten-free
- Researching your destination
- Helpful resources
- Presenter’s experiences
Read a review of the presentation here
Gut microbiota
The art of fermentation
Sandor Elliz Katz, Fermentation revivalist, Tennessee, USA
- An explanation of how fermentation can transform foods:
- Pre-digests complex compounds
- Detoxifies some poisonous compounds in food
- Generates additional nutrients
- Generates bacteria as probiotics
- Ferment types:
- Wild fermentation
- Using starters
- Pure culture
- Back slopping
- Distinct physical form
- A wonderfully simple demonstration of how to make sauerkraut
Read a review of the presentation here
Probiotics in Clinical Practice: Evidence of Benefit, Mechanisms of Action, and Risks of Use: Part 1
Dr Jason Hawrelak ND, BNat (Hons), PhD
- What are probiotics?
- Species commonly used as probiotics
- Traditional and novel uses of probiotics
- Strain specificity of action
- Probiotics - mechanisms of action and diversity of action
- Evidence of benefits
Read a review of the presentation here
Probiotics in Clinical Practice: Evidence of Benefit, Mechanisms of Action, and Risks of Use: Part 2
Dr Jason Hawrelak ND, BNat (Hons), PhD
- Choosing an effective probiotic preparation
- Dosage considerations
- Risks and Adverse effects
- Probiotic Myths
Read a review of the presentation here
Nutrition and Intestinal Permeability
Dr Cuong Tran, Senior Research Scientist CSIRO
- What is intestinal permeability?
- What causes intestinal permeability?
- Is there a relationship between diet and intestinal permeability?
- Next steps / further research
Read a review of the presentation here
Bone health and density
Professor Laura McCabe, Michigan State University
- Basics of bone physiology
- Causes and mechanisms of reduced bone mass (disuse, diabetes, IBD)
- How diet can affect the composition of the intestinal microbiota
- How the gut microbiome influences bone health
- Practical clinical applications
Read a review of the presentation here
Small Intestinal bacterial Overgrowth (SIBO)
Small Intestinal Bacterial Overgrowth
Dr Nirala Jacobi, ND (USA)
- What is SIBO?
- Causes
- Signs and symptoms
- Diagnosis
- Treatment
- Nutritional and dietary management
Read a review of the presentation here
Small Intestinal Bacterial Overgrowth: case studies
Alison Stewart, APD
Alison Stewart has been practising as a dietitian for 25 years, mostly in private practice. When some of her clients with FODMAP intolerances did not improve using conventional dietetic strategies she began researching small intestinal bacterial overgrowth (SIBO).
Alison interprets the breath test results of each of her three client case studies. Based on her nutritional assessment and breath test results she then describes her dietetic management.