Is Dietitian Advice Useful?

[Webby1980]

Hi, I am only newly diagnosed with Crohns disease 7 weeks ago and was wanting to know if anyone has found it beneficial seeing a dietitian in relation to working out what foods are suitable and not suitable to eat? As this is all new to me, I am still going through the process of what to avoid. I realise that it is different for everyone as to what people can tolerate and I have looked at the thread of safe and unsafe foods which has been helpful, however I don't know if I would be wasting my time and money if I was to go to a dietitian. Any feedback would be great. Thanks

 

[Jennifer]

Dietitians can be hit or miss just like any doctor can be (not that I'm saying they're doctors). If you do see a good dietitian then I believe they can be helpful. I don't think you need to see one on a regular basis for the rest of your life but they do help you to make good decisions as far as eating healthy/eating foods you can tolerate that are nutritious and how to prepare them.

When I was first diagnosed I saw a dietitian and they helped my mom make good food choices for me (I was 9 so I don't remember too much). I do remember the foods my mom made for me though and the choices she made for me when we would go out to eat somewhere.

Everyone is different so what worked for me in the past may not work for you or even myself now 22 years later. But long story short I do think they are worth seeing.

 

[Ya noy]

After i failed all the patch tests (totally useless) and decided to trash my allergy meds (which weren't working anyway) I hired a nutritionist.

My primary goal was to attempt to isolate my food allergies, but that never happened because my allergies "wax and wane", meaning they come and go, and probably have more to do with stress levels, my immune system, whatever.

I felt my time and money with the nutritionist was well spent though because I learned a lot about how to control cravings, increase vitamin and mineral content to get the most nutritional value possible from food, and not from taking pills. It's also how I learned it's not just sugar or fat, but that most preprocessed foods have little nutritional value and are are loaded with very bad chemicals. Just because certain foods may sound healthy, doesn't make it true.

The nutritionist I saw is very well known. She's hired by major corporations to revise their employee cafeteria meals and menus, and goes on speaking tours. She's extremely knowledgeable and good at her job. I don't know that the same is true of others.

 

[nogutsnoglory]

I have seen two dietitians and found them to be very helpful in tailoring an eating plan. I am actually going to a third new one for a consultation in a few weeks.

 

[Beach]

Something that might of interesting, as it was an article I read this morning commenting on a piece that appeared in the British Medical Journal. Basically the internet is changing the way in which patients and dieticians along with other health care workers interact with each other. Much as the article mentions a dietician or other health care worker could be a good coach, helping you to find needed answers. Then again times are changing and internet sights such as this can be of great assistance also.

"Patients are the new doctors"

http://www.drbriffa.com/2013/04/23/...r+Briffa's+Blog+-+A+Good+Look+at+Good+Health)

snippet from the article:

....The same edition of the journal contains an account from someone – Dave deBronkart – who was diagnosed with advanced kidney cancer, and who’s doctor suggested he take a look at acor.org, an online resource for individuals with various forms of cancer. deBronkart posted a message on the site, and within two hours he: “got facts and practical advice that to this day don’t exist in any journal article or establishment website,” including information about the best treatments and side effects from those who had already experienced them.

The editor’s piece goes on to say: “The internet and online communities are often rightly criticised as sources of misinformation and bad advice. But deBronkart’s story illustrates the contribution that informed and engaged patients can make to the complexities of medicine.” deBronkart is quoted as saying: “The value delivered by skilled clinicians is still there, but now we can see that it’s no longer the only source,” he writes. “Please, let patients help improve healthcare. Let patients help steer our decisions, strategic and practical. Let patients help define what value in medicine is.”...

 

[Webby1980]

I do have an appointment next week to see a dietitian of which I was considering cancelling however based on the couple of responses I have received I think I will keep it and go along to see what advice they have.

 

[nogutsnoglory]

What made you want to cancel? Was it a financial concern or you just thought it wasn't worthwhile?

 

[Webby1980]

In all honesty, the reason I wanted to cancel as I have had that many doctors appointments, tests and consultations recently I am just sick of going to them and of course the financial aspect also. I have spent so much money at doctors and pharmacy over the past couple of years trying to work out what was wrong with me and the cost over the past two months since being diagnosed with CD has been quite a bit.

 

[nogutsnoglory]

I hear you completely but this visit will be unique from your others since most doctors never discuss diet and certainly not in detail. You also can go once or twice it doesn't have to be a regular thing.

 

[GutlessWonder86]

I've seen a dietician several times since I was first diagnosed with Crohn's. She was very well versed in Crohn's and helped me very much especially when my iron was low.

Now that I get iron infusions, I use the other diet information when I flare up.

 

[amrycrohns]

If you can see a nutionist that deals with crohn's or atleast IBS in general it can be beneficial. When I first seen just general nutrionist at the local hospital she was completely lost and just recomended I see a specialist. After seeing a specialist (nutrionist) she basically just helped me track what foods I ate when and what symptoms I have so I could eliminate trouble foods which I could have probably done on my own. She did monitor my blood work better then my primary, so some benefit in knowing what you are deficient in or good on.

 

[UnXmas]

I didn't find them helpful. Working out the best diet for me was something that needed trial and error, rather than the expertise of a dietician. Since different foods suit different people - even people with the same illness, Crohn's - they can't know what's best for you any more than you can yourself. There are some ideas that apply to quite a lot of people - e.g. eating little and often, experimenting with different amounts of fibre to deal with constipation or diarrhoea, increasing of decreasing the amount of calories you consume to gain or lose weight, but this information can easily be found in books or online. Also sometimes you may find that guidelines that are suitable for most people don't apply to you - for example, a lot of advice I've been given said that if you feel too full, by gradually increasing your portion size, you'll eventually be able to manage larger portions and feel hunger again. I tried this, but my hunger never came back, and my feelings of fullness seem to get worse.

I'm not exactly sure of the difference between a dietician and a nutritionist, although I believe in the UK at least, dieticians have qualifications based on more medical or scientific knowledge. Dieticians work for the NHS, whereas nutritionists don't as far as I'm aware. That would match my experiences - nutritionists seemed far more interested in alternative therapy. This was no good to me either. They (I tried seeing a couple of different nutritionists) told me I was allergic to various foods that actually gave me no problems, and wanted me eating "whole foods" full of fibre that upset my digestion and restricted me to a very limited diet.

Possibly a dietician (or a nutritionist) would be useful if you're unsure of the basics of a good diet and aren't able or don't want to research information youself. I think some people may really benefit from the motivation to improve their diet which a dietician could provide. But I didn't find them beneficial.

 

[Jennifer]

Sounds like the ones you saw were terrible UnXmas. I recall you mentioning the story about their claiming you're allergic to certain foods. Mine never did anything like that. Having someone to report back to and offer new advice and suggestions is what I liked about mine. Their feedback was helpful. Like I said, finding a good one is key as they can't be hit or miss.

Increasing food portions over time may make sense for someone without IBD but if the issue was a stricture then that's just outright dangerous/bad advice. My nutritionist had me reduce my fiber intake a lot as fiber can cause more problems during a flare.

 

[hbrekkaas]

I think nutritionists *can* be useful, depending on where you are starting out. If you are at a loss with what to eat, or what is good for you vs. not so good, how much to eat etc. then yes, they are useful.

If you already have a pretty good idea of what to eat and what foods bother you, then no, they probably aren't going to add too much that you don't already know. But that was just my experience.

 

[Ya noy]

I should mention that I wasn't actually planning on seeing a nutritionist, and only did so because she was highly recommended to me by others at my gym. Who were former clients, well satisfied with the results they had achieved. Couple of them had even won some championships, and attributed their success to her coaching.

I personally feel I've gotten better results from consulting based on recommendations, then on credentials.

 

[Jennifer]

I wasn't seeking one out either. My GI sent me to one.

 

[alex_chris]

They can be useful. The ones I had been after I was diagnosed weren't because they didn't quite understand Crohn's and rather stuck to their routine "do's and don'ts" list which doesn't work for an individual. At that time specific advise from Crohn's patients who handling their diet well would have been much better.

 

[bangarang]

Eh, if your insurance is paying for it then okay but personally I would never spend money on a dietitian. You can get some solid advice on here what foods to eat and avoid and learn and experiment with other peoples experiences.

 

[amrycrohns]

I don't think the main thing they offer for us is what foods to eat since it varies a ton from individual to individual. They can monitor blood closely and suggest foods that are tolerable that you need to eat to maintain a healthy balance. My primary hardly ever orders blood work and only since I have been seeing a hemotologist has someone beside a dietician been monitoring my blood work.

And I agree with if it's free go for it, if it's gonna cost me I would pass on it.