Dietitian Doctor Letter

Thank you for referring 62-year-old male for assessment regarding Irritable Bowel Syndrome (IBS). He has been experiencing symptoms of IBS for approximately 6 months, including abdominal pain, bloating, and altered bowel habits, significantly impacting his daily life and ability to work. He expressed a high level of motivation to make dietary changes to manage his symptoms. Medical history includes hypertension, managed with medication, and a recent colonoscopy that ruled out any structural abnormalities. The colonoscopy was performed on 12 September 2024. He lives with his wife, is retired, and has a strong support system. Bowel habits are variable, with alternating episodes of constipation and diarrhoea. He reports occasional mucus in his stools. Medications: Lisinopril 10mg daily for hypertension. Assessment: Patient reports a typical Western diet with regular meal patterns, but often skips breakfast. He enjoys a variety of foods but avoids dairy due to perceived intolerance. A 24-hour recall revealed a high intake of processed foods and limited fibre intake. He reports food security. His eating pattern shows a low intake of core food groups, particularly fruits, vegetables, and whole grains. He consumes a moderate amount of meat and meat alternatives. He identifies several food triggers, including high-FODMAP foods such as onions, garlic, and apples, which exacerbate his symptoms. He recently attempted a low-FODMAP diet for two weeks, with some improvement in symptoms, but found it difficult to adhere to. He reports emotional eating, particularly when stressed, leading to increased consumption of trigger foods. He reports moderate stress levels related to his health concerns, which appear to worsen his IBS symptoms. Anthropometry: Current weight: 85 kg, Height: 178 cm, BMI: 26.8 kg/m2. He has experienced a slight weight gain of 2 kg over the past year. Impression: Patient presents with IBS, likely triggered by dietary factors. Recommendations include a modified low-FODMAP diet, focusing on identifying and eliminating trigger foods, increasing fibre intake gradually, and incorporating stress-reduction techniques. We will also focus on regular meal patterns and adequate hydration. Review appointment suggested in 4 weeks. Once again thank you for the referral, I look forward to assisting in the management of IBS.