Dietitians have ‘very diverse, rich roles,’ add value to the IBD care team
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LAS VEGAS — Partnering with a dietitian who specializes in inflammatory bowel disease can augment patient care through nutritional assessment, dietary counseling and perioperative optimization, according to a presenter.
“Sometimes people just think we’re calorie-counters,” Kelly Issokson, MS, RD, CNSC, a registered dietitian and clinical nutrition coordinator at the F. Widjaja Inflammatory Bowel Disease Institute at Cedars-Sinai, told attendees at the Crohn’s & Colitis Congress, “but that’s not true.”
![“I always make sure to counsel my patients and let them know symptoms don’t correlate with disease activity. The most important step moving forward is that we make sure [they] stay in remission long-term, so that disease activity doesn’t kick back up.” Kelly Issokson, MS, RD, CNSC](/~/media/slack-news/gastroenterology/misc/infographics/2024/0124/hgi0124issokson_ccc_graphic_01.jpg?w=800)
She continued: “We actually have very diverse and rich roles. For me, my role has not always been the same. Part of that is learning how I can add value to the team and the other part is the team recognizing the value that I bring and providing me with opportunities for growth and professional development.”
In her presentation, Issokson explained how dietitians can become integrated into a multidisciplinary team, based on their education background, experience and available resources.
What do dietitians really do?
A key role of the IBD dietitian is to perform a comprehensive assessment of a patient’s nutrition status, which often includes evaluating:
- current diet/relationship with food and eating,
- physical examination and weight changes,
- medication and supplement intake,
- medical history and disease activity,
- biochemical markers; and
- nutritional needs.
“When we do identify nutritional problems, it’s important that we implement appropriate intervention, that we’re able to monitor and evaluate the effectiveness of that intervention, and then, depending on the level of nutrition risk, we’re going to want to see them at specific follow-up intervals,” Issokson said.
The next step in care is providing dietary counseling. Issokson noted this often involves making dietary modifications for general health or symptom management, reducing risk for cancer, reintroducing and identifying “safe foods,” and providing guidance on how to eat during a flare or in remission.
“I always make sure to counsel my patients and let them know symptoms don’t correlate with disease activity,” Issokson said. “The most important step moving forward is that we make sure [they] stay in remission long-term, so that disease activity doesn’t kick back up.”
In addition to providing both preoperative and postoperative dietary education for patients, dietitians also bolster cross-disciplinary collaboration through program development, teaching and menu development, as well as participation in research projects.
“I would highly recommend going to an academic center and finding a dietitian that fits your needs and can add value to your team,” Issokson said. “If there’s not one near you, there’s also dietitians in private practice that are really wonderful.”
She continued: “Build rapport and support that dietitian ... If you can support their continuing education, they’re going to be more able to fulfill those competencies and be able to see those complicated IBD patients and support them with evidence-based therapies.”
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Issokson K. Dietitian: Not just for the malnourished. Presented at: Crohn’s & Colitis Congress; Jan 25-27, 2024; Las Vegas.
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