ROLE OF DIETICIAN, NUTRITION CONSULTANT IN A GI PRACTICE

DIET IS THE PRIMARY TREATMENT FOR:

  • Lactose intolerance
  • Fructose intolerance
  • Sucrose intolerance
  • Celiac disease
  • Metabolic dysfunction-associated steatotic liver disease (MASLD)
  • Post-ostomy output/ hydration management

THERAPEUTIC DIETS THAT Gl DIETITIANS SPECIALIZE IN:

  • Gluten-free
  • Low FODMAP
  • Fiber modified diets (e.g. Gl soft, low particle size, soluble vs. insoluble, high vs. low fiber)
  • Food chemical sensitivity diets
  • (e.g, low histamine, low salicylate, low tyramine, low
  • Eosinophilic Esophagitis elimination diets
  • Various carbohydrate-restricted diets (e.g. low lactose / fructose / sucrose, specific carbohydrate diet, low osmolality)
  • Other diet patterns to manage MASLD and cardio-metabolic disease (e.g.Mediterranean, low glycemic diets)

MANAGEMENT OF CO-MORBIDITIES

  • Diabetes.                                             
  • Hyperlipidemia 
  • Hypertension 
  • Osteoporosis
  • Disordered eating                     
  • Kidney disease
  • Obesity
  • Pregnancy & nursing
  • Cirrhosis
  • Managing side effects from medications and surgeries.

Reference: Gastroenterology 2025; 168:645-649. 

Eosinophilic Esophagitis: Tips for the Primary Care Provider – Practical Gastro GUILD-September-2024.pdf

Eosinophilic Esophagitis

This article summarizes content originally published in Practical Gastroenterology May 2025:

“Eosinophilic Esophagitis: Tips for the Primary Care Provider” by Author: Evan S. Dellon.

Eosinophilic esophagitis (EoE) is a chronic allergic condition that affects the esophagus, the tube that carries food from your mouth to your stomach. It’s becoming more common, so you might hear about it more often. If not treated, EoE can lead to problems like food getting stuck in the esophagus or narrowing of the esophagus.

To diagnose EoE, doctors look for specific symptoms and perform a test called an endoscopy, where they take a small sample from the esophagus to check for certain cells called eosinophils. Symptoms can include trouble swallowing, chest pain, and heartburn that doesn’t get better with usual treatments. In children, it might show up as poor growth or frequent vomiting.

Treatment for EoE includes changes in diet, medications, and sometimes procedures to widen the esophagus if it has narrowed. Dietary changes often involve removing common food allergens. Medications like proton pump inhibitors and special steroids can help reduce inflammation. There’s also a new medication called budesonide that’s been approved specifically for EoE. If these don’t work, another medication called dupilumab might be used.

Managing EoE is a long-term process, as the condition can come back if treatment is stopped. It’s important for patients to work closely with their healthcare team, which may include specialists like gastroenterologists and allergists, to keep the condition under control. Regular check-ups and following the treatment plan are key to managing EoE effectively.