Digestive Disease Dietitians 101

By Deborah Gerszberg, RD, CNSC, CDN
Clinical Nutritionist, Division of Digestive Diseases

Getting a new diagnosis may be nerve-wrecking on its own, but then being told you have to change your diet adds insult to injury!   Don’t worry though, one of our experienced dietitians can help you make changes, ease your stress, and help you understand the connection between your diet and your symptoms.

In honor of National Nutrition Month, we wanted to highlight how a digestive disease dietitian can help you.

Gastroesophageal Reflux Disease (GERD)

GERD may be painful and can greatly impact your quality of life. Small, more frequent meals, avoiding acidic, spicy or fried foods and eliminating beverages containing caffeine and alcohol can certainly help manage symptoms

Fatty liver disease

By limiting refined grains and sugars (especially from fructose) at the same time as increasing fiber intake and exercise, you may reverse fatty liver.

Pancreatitis

Patients are often scared to eat any fat after suffering from a pancreatitis attack.  Let our dietitians help you learn how to gradually add healthy fats back into your diet without aggravating your pancreas.

Pancreatic cancer

Many people who suffer from pancreatic cancer also experience weight loss, undergo surgery that impacts their digestion, and may not be able to adequately absorb important nutrients.  Diabetes is common in pancreatic cancer, and trying to gain weight while also trying to control blood sugar can be challenging.

Try protein rich snacks (like cheese or nuts); remember there is no restriction on the amount of fat in your diet.  Most patients need to take pancreatic enzymes, which are dosed based on your actual weight and adjusted for the dietary fat.

Diverticular disease

Diverticulosis is a condition where small pouches (diverticuli) form in the colon (large intestine).  If you have this condition, you should aim to have a high fiber diet, which includes at least 35 grams daily.

Diverticulitis is an acute inflammation of the same diverticuli and can be painful. While you have diverticulitis, a low fiber diet (<13 grams per day) is recommended until the inflammation is resolved – and then you need to resume a high fiber diet.

Note:   It is a myth that patients with diverticulosis must avoid corn, nuts, and seeds (although they should be avoided during acute diverticulitis).

Motility disorders

Gastroparesis is a common motility disorder affecting stomach emptying time and causing nausea, fullness, and sometimes vomiting. Reducing the amount of fat and fiber in the diet and having small frequent meals helps to alleviate the symptoms.

Irritable bowel syndrome (IBS)

IBS can be very debilitating, causing abdominal pain, diarrhea and/or constipation. A low FODMAPs  elimination diet may provide relief, but should be followed by a reintroduction of the eliminated foods to avoid negatively impacting your microbiome (the bacteria in your gut) which comprises 70% of your immune system.

Irritable bowel disease (IBD)

Crohn’s disease and ulcerative colitis are considered IBD, resulting from inflammation of the intestines. A low fat and low fiber diet is indicated during periods of abdominal pain and/or diarrhea. Certain probiotics may help induce remission for some people suffering from IBD.

Eosinophilic esophagitis (EoE)

Part of the treatment for EoE patients is a strict elimination diet where food allergens (wheat, milk, eggs, soy, peanuts, tree nuts, and fish/shellfish) are avoided completely for 6-8 weeks before a baseline biopsy of the esophagus.  One new food allergen is then introduced, and the biopsy is repeated 2-3 months after the introduction. This process is repeated one food allergen at a time to identify food triggers — which are highly individualized.

As you can see, there is not a “one-diet-fits all” approach to nutrition as a supportive treatment for digestive disease patients. Seeing a dietitian for individualized care is an important part of your treatment in the digestive disease program.

If you are a patient at Columbia University Medical Center and have any one of these conditions or any questions about your diet please e-mail us at Ginutrition@nyp.org.

We work closely with your doctors to maximize your comprehensive treatment plan and we are a complementary service.

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