Once you have had appropriate investigations undertaken by your Consultant Gastroenterologist, to confirm that IBS is the correct diagnosis you are likely to find considerable benefit from the Low FODMAP approach, which is helpful in 70-75% of IBS patients who will then be able to self-manage their symptoms in the long term.

Dr Millar, or your own specialist, will ensure that you receive the best treatment with other lifestyle changes and medical treatments when required.

Once you have identified your food intolerances, you will once again be able to enjoy cooking, family meals and eating out.

Some patients require a less formal approach then the FODMAPS diet, particularly when symptoms are mild or improving, and in this case we will offer the ‘first line’ dietary advice, based on National Institute of Clinical Excellence (NICE) guidelines.

You can read more information in the Irritable Bowel Syndrome and Diet fact sheet on the British Dietetic Association (BDA) website, on the ibsnetwork website and on The Guts UK website.

Begoodtoyourgut blogs on this subject include:

1. Irritable Bowel Syndrome should I be taking probiotics and prebiotics?
2. Lifestyle therapies to help in the management of Irritable Bowel Syndrome
3. An introduction to the Low FODMAP diet

You may also want to consider looking at NHS Webinars on diet (https://patientwebinars.co.uk/condition/ibs/webinars/) and additional lifestyle information on the management of Irritable Bowel Syndrome.

Sian is fully trained as a Low FODMAP practitioner by the team at Kings College London. She also regularly attends update sessions undertaken by this team at Kings College and Guys and St Thomas’s Hospital, to ensure her knowledge and skills are regularly updated.

You will be provided with the latest resources produced by Kings College London, in association with Guys and St Thomas’s Hospitals, in addition to recipe suggestions and signposted to helpful apps to support you identify which foods are high in fermentable carbohydrates and which are suitable alternatives. Sian’s approach is holistic. She will provide guidance on activity/exercise and stress management strategies, in addition to diet, where appropriate.

Coeliac disease affects all ethnic groups and is common in Europe and North America.  It affects at least 1 in 100 people in the UK and in Europe; however, only about 24% of people with the condition are clinically diagnosed and this unfortunately can take on average a very lengthy 13 years.

The only treatment at present is lifelong adherence to a strict gluten-free diet. Obvious sources of gluten include flour and flour based foods, breads, pasta, cereals, cakes and biscuits. If a gluten-free diet is not followed, the disease can ultimately lead to nutritional deficiencies, osteoporosis, anaemia, cancer of the small bowel and unexplained infertility problems.

Following your diagnosis, a consultation with Sian will include an individual assessment of your current diet and equip you with practical advice on where to access gluten free foods, avoid food cross contamination, accessing gluten free restaurants/cafes, travelling overseas and avoiding where possible dietary deficiencies including iron, calcium and fibre.

Sian recommends patients consider joining Coeliac UK. It is a fantastic source of general advice, particularly additional dietary support: on all matters related to your disease, new food products as they become available, recipes and access to the excellent Food and Drink directory and GF Checker app which will help you when out shopping:

You can read more information on the Coeliac UK website or within the Coeliac Information entry on the Guts UK website.

Begoodtoyourgut blogs on this subject include:

1. How to prepare for and what to expect at your Coeliac review

NICE Quality Statement 5 (2016):
‘recommends considering the need for specialist nutritional advice as part of the patient’s annual coeliac review’

It is thought that there are around 240,000 people in the UK with inflammatory bowel disease These are lifelong conditions and most commonly first present in the teens and twenties. Men and women are equally affected.

Some patients with active disease can become undernourished as a result of an inadequate dietary intake, increased nutrient requirements and sometimes-excess losses due to poor digestive absorption, in association with drug interactions.  People can also over restrict foods in an attempt to self manage their symptoms. Studies have shown that adult patients with Crohn’s disease can have lower levels of Vitamins D, K, Vitamins B1 and B6 and also zinc. Anaemia can also become an issue if there is intestinal bleeding and Vitamin B12 deficiencies can occur in some patients after surgery.

Some patients with Crohn’s disease have strictures identified, requiring them to limit fibrous i.e. pulses, fruits, vegetables and wholegrain foods. Lactose can also be poorly tolerated in some Crohn’s patients.

Sian will help provide you with clear guidance on optimising your dietary intake and provide you with effective, ‘evidence based ‘nutritional support strategies for managing your condition.

You can read more on Crohn’s and Colitis website on Crohn’s Disease on Ulcerative Colitis. Both of these can be  accessed directly on the Guts UK website.

2013 Standards for the Healthcare of People who have Inflammatory Bowel Disease (IBD)
Standard A5 – ‘Access to a Dietician should be available to all IBD patients’.

2013 Standards for the Healthcare of People who have Inflammatory Bowel Disease (IBD)
Standard A5 – ‘Access to a Dietitian should be available to all IBD patients’.

This is the medical term used to describe the small pockets that stick out of the side of the large intestine (colon).

Diverticula are common and associated with ageing. One in four people who develop diverticula will experience symptoms, such as bloating and abdominal pain; other people will experience no symptoms at all. Diverticula are identified at colonoscopy or computerised tomography (CT scan).

Diverticulitis occurs when these pockets become inflamed or infected requiring prompt medical attention. If this is the case, it may necessitate a short period of time on a fluid and/or very low fibre diet.

People aged 50-70 who eat a high-fibre diet (25grams a day) have a 40% lower chance of admission to hospital with complications of diverticular disease – compared to others in this age range with the lowest amount of dietary fibre.

Most people with diverticular disease are however recommended to eat up to 30grams (1oz) of fibre a day.

Sian will advise you how to practically achieve a higher fibre diet (or in the case of severe diverticulitis, a fluid or very low fibre diet may be required in the short term), based on an assessment of your current intake of dietary fibre. You may find that you can tolerate certain fibres better than others for example soluble fibre – oats, fruits, vegetables and pulses. She will then aim to help you achieve an optimal amount of soluble and insoluble fibre daily, in addition to ensuring you have sufficient fluid in your diet.

Fibre supplements, usually in the form of sachets of powder that you mix with water may also be suggested.

You can read more information on the Fibre fact sheet on the British Dietetic Association (BDA) website or on the Diverticular Information section on the Guts UK website.

It is very important that the underlying cause of your symptoms is fully investigated by your GP and Consultant. GORD is however a very common disorder affecting one in ten people on a weekly basis and can often improve with weight loss and other small dietary changes, including modification to eating behaviours, in association with antacids and low dose proton pump inhibitors.

Sian will ask  you to fill in a food and exercise diary on our website, including your weight and height.

She would then arrange to speak to you either at BMI Cavell. If that is not convenient a Facetime or Skype consultation may be arranged.

You can read more in the Heartburn & Reflux information sheet on the Guts UK website or on the NHS Choices website.

Begoodtoyourgut blogs on this subject include:

1. Managing acid reflux in the festive season

Is caused by a build up of fat in the liver. It is usually associated with being overweight and is linked to an increased risk of high blood pressure, an elevated blood glucose (sugar) levels, which can lead to diabetes, and an increased amount of fat (triglycerides or cholesterol) in your blood.  In some people the fat can lead to inflammation of the liver, causing the same type of damage as excess alcohol and can in extreme cases lead to cirrhosis and liver tumours. This is called non-alcoholic steatohepatitis and affects 2-5% of the population of the UK. Around 30% of the UK population has the mild version (non-alcoholic fatty liver disease – NAFLD). Fatty liver disease is usually picked up on a routine blood test or ultrasound scan.  A healthy liver will contain little or no fat.

For most people with NAFLD, the good news is that in most cases, it responds well to changing to a healthy diet, losing weight and increasing the amount of exercise you undertake.

Andrew or your own specialist will ensure that the correct investigations are carried out to ensure the diagnosis is correct and commence or recommend any medical therapy that you require and advise on lifestyle changes that might be needed.

Sian can help guide you address both weight loss and improving your diet, in addition to providing dietary support if you have high blood pressure or a raised cholesterol or triglyceride level. She will also discuss activity and exercise, aimed at achieving gradual weight loss as appropriate.

Prior to your consultation do try and have a look at the Healthy Eating Fact sheet and Weight Loss Fact sheet both found on the British Dietetic Association (BDA) website or the NHS Choices website.

Begoodtoyourgut blogs on this subject include:

1. The dietary management of non-alcoholic fatty liver disease (NAFLD)