Consultations via Zoom have taken a bit of getting used to, but they mean I can still cover all the important aspect of a dietary assessment and get a good insight into how food fits in to people’s lives.
Typically, I find it really handy to start by finding out exactly what the issues are that someone is struggling with and how this impacts on their life. In people who suffer gut symptoms such as diarrhoea, constipation or bloating, life becomes tricky and unpredictable and it’s easy to stop doing things you previously enjoy because you feel uncomfortable or want to keep close to the toilet. It’s not uncommon for people to have developed compensatory behaviours to help them manage these unpleasant symptoms, such as avoiding eating out, restricting their diet or fluids, eating only once a day, or avoiding using the toilet at work or in public places. These things might help in the short term but develop into their own issues over time. I regularly see people who feel at their wits end trying to figure out what to eat or avoid, when to eat and how to get their life back on track. It can be exhausting dealing with this on your own.
Whilst going into detail about symptoms with someone you’ve only just met might feel embarrassing to start with, it is really helpful to give a better understanding of what might be going on- and there is honestly nothing I haven’t heard before! Often it can be helpful to write down what you eat and drink for a few days alongside some detailed information about your symptoms. This can sometimes show a clear pattern emerging but other times a pattern is a little trickier to distinguish. This is where the skill of a dietitian really lies as we can see how the different foods might relate to each other, for example foods considered more fermentable and different types of fibre. There isn’t always a pattern or sometimes food just isn’t part of the problem and the advice might be around going back to discuss the symptoms with the GP- but worse case scenario you and your Doctor can rest assured that food isn’t the issue so you can move on to look at other possibilities.
Once we’ve established what your symptoms are doing and how this fits in with what you eat every day, its time to talk about possible dietary approaches. Advice is always evidenced based so you can trust that what I’m telling you isn’t just because it worked for a friend’s neighbour! I like to let people know that they are not obligated to follow the advice that is discussed, in fact it should be seen it as a sort of ‘fact-finding’ exercise. Id like to think I give people enough information for them to be able to make an informed decision about what they do next and if they do decide to make changes to their diet, I’m there to support them through that as much as needed.
Sometimes only one appointment is required, and you may feel you have all the information you need. Others come back for follow up appointment to discuss how things are going and what changes there have been with the symptoms. It might be the case that we agree to stick with the plan as things are working or we might think about changing tack altogether to try something else. Everyone’s body is different and what works for one person might have no effect on another, that’s why getting all your advice from general internet posts isn’t always the most helpful way forward!
Find out more at www.wearehealthcare.co.uk