Dietician or Gastroenterologist? Picks for IBS Relief

Medically Reviewed by Sabrina Felson, MD on November 02, 2021
2 min read

If you have irritable bowel syndrome (IBS), then you've had to deal with diarrhea, constipation, bloating, and stomach pain. Doctors don't know exactly what causes IBS, and there's no cure to stop it. But treatments can help ease your symptoms.

You may choose a dietitian or a gastroenterologist (a doctor who specializes in the digestive tract), or both. Understanding what each does can help you make the best pick.

RDNs are dieticians who have advanced degrees and have more training than regular nutritionists. They take continuing education courses and should know the most current information on food and nutrition sciences. If you suspect your diet is to blame for your IBS symptoms, an RDN can help you find relief. 

They may ask you to keep a food diary to pinpoint the foods that may trigger your symptoms. The diary may help rule out foods that you thought were causing you trouble. RDNs may gradually add fiber to your diet. That may help food move at a more normal speed through your digestive tract. Adding too much fiber too quickly can cause problems. But RDNs should know the right pace for you.

Your RDN also can help identify the best mix of foods for your symptoms. They may suggest you steer clear of foods high in certain carbs that can cause IBS symptoms. If you follow the "low-FODMAP" diet, you need to avoid some fruits, vegetables, sweeteners, and dairy products that can cause diarrhea, bloating, and other discomfort. Your RDN can guide your diet safely over a month or two. If that helps, they can then help you add back the missing foods to better balance your diet.

If diet alone isn't the cause of your pain and discomfort, you may need to seek the care of a gastroenterologist. This is a doctor who specializes in problems of the digestive system. Unlike a registered dietician-nutritionist, a gastroenterologist can prescribe drugs. They also can recommend lifestyle changes and offer guidance on how to change your diet.

They can prescribe medicine such as:

  • Anti-diarrheal medication
  • Laxatives for constipation
  • Fiber supplements for constipation
  • Drugs to reduce muscle spasms in your bowels to reduce bathroom visits
  • Drugs to curb stomach pain or bloating
  • Antidepressants, which at low doses may ease digestive tract pain

Many people who have IBS also have a lot of stress or anxiety and are more likely to be depressed. Getting rid of stress can often ease your IBS symptoms. For this reason, your doctor may suggest you see a mental health therapist. A talk therapist can teach you the best ways to handle stress when IBS symptoms crop up. Your doctor also may recommend you see an RDN. 

You also could lower your stress if you:

  • Sleep more
  • Exercise often
  • Stay out of stressful situations
  • Meditate or do yoga

Your doctor may suggest you try alternative treatments like hypnosis or acupuncture. They can help with triggers like stress and anxiety.