What do IBS Dietitians do?

By Sascha McMeekin, IBS Dietitian

If you are reading this page, it is highly likely that you are living with Irritable Bowel Syndrome (IBS) and have never seen a specialized dietitian before. Living with chronic gut symptoms can be exhausting and overwhelming, but you do not have to figure it out alone.

Let’s get you up to speed on exactly what an IBS and Low FODMAP Dietitian does and how they can help you reclaim control over your gut health.

The Qualification: Dietitian vs. Nutritionist

Firstly and foremost, all Dietitians are university-qualified health professionals. They have completed either a four-year undergraduate Bachelor’s degree or a 2 year Masters of Dietetics following an undergraduate science degree. Their rigorous training combines a foundation in human physiology and biochemistry with practical studies in medical nutrition therapy and counselling.

In Australia, the title of Accredited Practising Dietitian (APD) is a credential governed by Dietetics Australia. It is the only nutrition credential recognised by Medicare, the Department of Veterans Affairs, and most private health funds.

What sets a Dietitian apart from a Nutritionist?

While qualified nutritionists share a similar foundational knowledge of physiology and chemistry they are not trained to assess, diagnose, or delivery dietary therapist for specific medical conditions. Instead, nutritionists are trained to address broader health and wellness issues affecting the general population.

Beyond their university degrees, all dietitians must complete mandatory continuing professional development (CPD) hours every year to maintain their accreditation. However, they can choose which areas of health they focus on.

What sets IBS & Low FODMAP Dietitians apart:

As you might expect, we focus our advanced, ongoing training entirely on functional gastrointestinal disorders. The most widely recognised training is through Monash University, the industry leader in FODMAPs and IBS research. I was proud to be one of the first Dietitians to complete the Monash University FODMAP training course in 2018.

You can bet that an IBS Dietitian dedicates all of their continuing professional development hours to staying at the forefront of gut research. This ensures that you receive the most accurate, safe, and up-to-date dietary strategies to treat your symptoms.

The Consultation: What to Expect

Dietetic consultations can be held in-person or via secure videoconference, usually lasting up to 1 hour.

Before your first session, you will likely be asked to fill out a new client intake form. This information will be used to identify you for record keeping. My new client forms also ask about your medical and nutrition history because in certain cases, medical histories can be complex, IBS symptom history can be lengthy and remembering what you regularly eat is harder than you think! Providing this information ahead of time ensures you get the most out of your session.

Note: If you have been asked to complete a food diary, please do your best to keep it as accurate as possible. Your Dietitian is a partner working with you, not a judge. They have seen every kind of diet imaginable, no food habit will surprise them. The more detail you can provide about brands and portion sizes the better!

During your initial consultation, the conversation will open with what you hope to achieve. This ensures your expectations are met and that the session is tailored entirely to your goals.

Questions to expect:

After reviewing the details of your medical history, medications, supplements, recent blood tests and family medical history, your dietitian will look into the specific investigations you have already undergone.

For example, if you’ve had a coeliac blood test, they will want to know:

• Were you eating sufficient gluten-containing foods at the time?

• Was the test completed in the last 3-4 years?

These questions are to double-check your IBS diagnosis is accurate and there is no other underlying medical condition is causing your gut symptoms. The symptoms of IBS overlap with many other medical conditions, including:

• Coeliac disease

• Inflammatory bowel disease (IBD, such as Crohn's or Ulcerative Colitis)

• Endometriosis

• Bowel cancer

It is vital to ensure nothing has been missed along the way, and that no new red-flag symptoms have arisen since your initial diagnosis.

Investigating the Root Cause

To help pinpoint the driving factors behind your symptoms, your dietitian will gather information regarding:

Other important information will be gathered relating to your weight and weight history, cooking and shopping role in the family, any exercise you do, stress levels, and sleep.

Next comes the comprehensive dietary analysis. Your IBS Dietitian will need to know what you eat in a typical day to be able to help you in a targeted way. They will assess for specific IBS triggers while analysing your overall nutritional intake, fibre types and amounts, fluid adequacy and eating behaviours (e.g. do you routinely eat in a hurry or stand up during lunch breaks?).

Questions you may not expect:

A thorough IBS assessment should confirm the IBS diagnosis and make sure all the relevant health professionals are involved in your care. In order to this, they may ask some of the following questions:

• Are you periods regular? What types of symptoms do you experience before or during a period? Are they mild or severe?

  • Why we ask: Women with endometriosis frequency present with IBS-like symptoms. Women with IBS have a 3 fold risk of an endometriosis diagnosis. Although treatments for IBS are very effective at managing the gastrointestinal symptoms associated with endometriosis, endometriosis can lead to chronic pain and fertility challenges that require separate medical management.

---

• Have you noticed yourself worrying or feeling anxious? How have you been handling things emotionally? In the past 2 weeks have you felt sad, down or hopeless?

  • Why we ask: Due to the gut-brain axis, roughly 30% to 40% of people living with IBS also experience anxiety and/or depression. These questions help determine whether a further mental health assessment and/or psychological referral could help calming your nervous system and your gut. IBS Dietitians work within a multidisciplinary team and will only suggest these referrals with your explicit permission.

---

The Plan

Once the assessment is complete, your IBS Dietitian will establish a clear nutrition diagnosis and outline a personalised path forward.

Your comprehensive management plan may include:

• Targeted dietary recommendations: Education and structured guidance on specific dietary therapies, such as the temporary Low FODMAP diet. This comes complete with educational resources, food swaps, sample meal plans, shopping lists, and specific product recommendations. It is important to note that just because your IBS Dietitian has low FODMAP training, does not mean that you will always be recommended a low FODMAP diet. If you are already on a low FODMAP diet, your IBS Dietitian can help you broaden your tolerance to FODMAPs. If you have tried a low FODMAP diet without success, your IBS Dietitian will be ready with alternative recommendations.

  

  • Nutrition optimisation: Ensuring your diet remains balanced. Managing IBS is integrated into the bigger picture of your overall longevity, making sure you reach your required macronutrient and micronutrient intake while managing symptoms.

  • Microbiome and gut health support: Addressing potential gut dysbiosis (an imbalance of gut bacteria) to optimize long-term gut health, working towards eventually tolerate a wide variety of foods.

  • Specific Supplement Protocols: While most specialized dietitians practice on a "food-first" basis, supplements like targeted probiotics, specific fibre supplements, vitamins, or digestive enzymes can play a pivotal role. Recommendations will always specify the exact brand, dose, frequency, and timing.

  • Further medical testing: A formal letter to your GP or Gastroenterologist requesting specific investigations to check for nutritional deficiencies or rule out overlapping conditions.

• Multidisciplinary Referrals: Connecting you with specialized external providers if necessary, such as gut-directed psychologists or pelvic floor physiotherapists.

 *Any recommendations made are accompanied by education materials to equip you with the knowledge and skills to adapt your diet in the long-term, not just following specific instructions in the short-term.

Finally, your IBS Dietitian will map out the short- and long-term plan for managing your condition, establish when to meet next and outline how you will be supported between appointments. In my practice, all consultations include unlimited email support between sessions, meaning you never have to wait weeks to get an answer to an urgent question.

Ready to take control of your gut health?

If you're ready to stop guessing and start healing with expert, evidence-based care, you can book your consultation here.

Hi, I'm Sascha McMeekin - Accredited Practising Dietitian and IBS Dietitian.

After seeing the profoundly positive impact I can have on the lives of IBS clients I decided to dedicate my practice to just that. Helping people like you feel better, and give you the tools to manage you IBS long-term while improving your gut health along the way. 

What matters most to me is providing a quality service, based around research and care for each individual. Let me share more about myself with you.