Individuals with Digestive Diseases Experience Food-Related Anxiety and Decreased Quality of Life

People who use dietary modifications for the treatment of digestive diseases such as eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) experience a decline in food-related quality of life, according to an analysis presented during Digestive Disease Week 2024.

Patients with digestive diseases generally report a decline in health-related quality of life after diagnosis. In a recent study conducted at the Northwestern University Feinberg School of Medicine, in Chicago, Illinois, Margaret Fink, MD and colleagues assessed food-related quality of life (FrQOL) in patients treated for IBD, celiac sprue (CS), achalasia (ACH), and EoE. FrQOL is a newer metric that has been created to measure the impact of diet, eating behaviors, and food-related anxiety on health-related quality of life.

“Patients with gastrointestinal diseases often use dietary modification, either self- or physician-directed, as a symptom management strategy,” Fink said. “While dietary modification may prove beneficial for these patients, the effect of such dietary choices may have implications for the quality of life of these patients and their experience surrounding food and eating.”

The study included nearly 300 adults with digestive diseases, who were recruited at an outpatient university-based gastroenterology clinic and through social media. The most common diagnosis was IBD (42%), followed by celiac sprue (24%) and EoE (18%). All participants completed an online survey that included the Food-Related Quality of Life questionnaire and several other instruments that collected demographic data and disease-related information, including the use of dietary modification. Most participants reported that they followed either a self-directed (53%) or physician-prescribed (28%) dietary therapy. Almost half of the responders (46%) said that they had consulted a dietician.

The results showed that FrQOL was significantly reduced across all disease groups. Patients diagnosed with different digestive diseases reported similar levels of FrQOL, with the exception of those with EoE reporting a significantly greater disease impact on FrQOL than patients with IBD.  One-third of participants used a dietary treatment without consulting a dietitian, whereas 31% who used dietary modification reported that they had met with a registered dietician. FrQOL scores were significantly higher for individuals who did not used diet therapy compared with those who used dietary modifications, with or without the support of a dietician. Dietary consultation did not appear to have an impact on the FrQOL metric. Those with lower food-related quality of life also reported lower levels of social and physical functioning.

“Food-related quality of life appears to be significantly degraded in many patients with achalasia, celiac sprue, IBD, and EoE, which aligns with prior research in this area,” the author concluded. “Use of dietary treatment, as well as meeting with a registered dietitian, regardless of specialization, are also associated with lower FrQOL. Following a restrictive diet would likely reduce FrQOL, however, it is unclear if patients sought assistance from a registered dietitian before or after FrQOL declined. Future studies on the relationship between dietary treatment, dietitian support, and FrQOL are warranted.”