Dietician or Gastroenterologist? Picks for IBS Relief

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.

So who should you see for help? Do you need to see a stomach specialist (gastroenterologist)? Or could a dietician offer you a better shot at relief? Understanding what each does can help you make the best pick.

Registered Dietitian Nutritionist (RDN)

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. 

She 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. An RDN 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 an RDN should know the right pace for you.

Your RDN also can help identify the best mix of foods for your symptoms. She 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, she can then help you add back the missing foods to better balance your diet.

Gastroenterologist

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. He also can recommend lifestyle changes and offer guidance on how to change your diet.

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He 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.

WebMD Medical Reference Reviewed by Lisa Bernstein, MD on April 25, 2017

Sources

SOURCES:

American College of Gastroenterology: "Irritable bowel syndrome."

Mayo Clinic: "Irritable bowel syndrome."

Academy of Nutrition and Dietetics:  "Irritable bowel syndrome," "Qualifications of a registered dietitian nutritionist."

National Institute of Diabetes and Digestive and Kidney Diseases: "Treatment for irritable bowel syndrome."

FDA: "Irritable bowel syndrome treatments aren't one-size-fits-all."

International Foundation for Functional Gastrointestinal Disorders: "Cognitive behavioral therapy for IBS."

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