This role statement was developed by members of the Gastroenterology Interest Group.

It lists the knowledge and skills of an Accredited Practising Dietitian (APD) working in gastroenterology.

Knowledge

• Normal capacity and function of secretion, digestion and absorption of foods.
• Knowledge of the wide range of conditions, diseases and surgical procedures that could impact on the gastrointestinal system, and options for nutritional intervention.
• Sites of digestion and of absorption of macronutrients and micronutrients
• How GI dysfunction, surgical resections, disease, and gut microbiota affect nutrition and health
• Knowledge of evidence-based pathways of care for patients with GI disorders based on disease and treatment type including recognition of appropriate time points for nutrition screening, assessment, intervention and monitoring
• Value and limitations of enteral and parenteral formulas, evidence-based therapeutic diets, probiotics, common nutraceuticals and other common adjacent therapies

Skills

• Recognise extremes of dietary intake and the effects of diet on GI function and symptoms
• Identification of gastrointestinal symptoms that may be due to poorly managed or undiagnosed GI disorders
• Can explain the relative strength of association between therapeutic diets used to manage or treat GI disorders and outcomes expected
• Predict nutritional inadequacies, intolerances, or complications resulting from dietary inadequacies, GI disease and/or resections
• Estimation of nutritional requirements (energy, macronutrients, micronutrients, fibre and fluid) relevant for specific GI disorders accounting for variations that occur due to fluctuations in condition stability, medical therapy outcomes and gastrointestinal losses.
• Ability to provide evidence based, specific and tailored advice to the individual with the GI disorder, considering the changing physiological and psychosocial needs related to disease state and treatment (pharmaceutical, surgical, psychotherapy, dietary, biological therapies).

Activities entry level APDs would conduct

• Select and use screening tools appropriate for identifying patients with GI disorders who are at nutrition risk, those who need further evaluation and/or those who need intervention including referrals to Gastroenterologist/GI Surgeon
• Completing the Nutrition Care Process in collaboration with the patient, and, where appropriate, family and multidisciplinary team, with a particular focus on gastrointestinal symptoms such as nausea, vomiting, bowel habits, signs of indigestion and malabsorption and their impact on nutrition and relationship to gastrointestinal disease.
• Understand and provide education to the patient/client and carers/family about the potential benefits and consequences of dietary interventions for GI disorders

Activities APDs working at a higher level would conduct

• Identify whether dietary practices, inadequacies or intolerances are contributing to current GI condition or GI symptoms
• Evaluate the value of specialty nutrition products for certain GI disorders
• Care coordination of patients with complex nutrition needs and/or a high level of dietetic input within a multidisciplinary team for example,intestinal failure service

For more, download the full role statement. The full statement includes a list of document references.