Understanding dietary beliefs, behaviors, and barriers in inflammatory bowel disease: A scoping review

BACKGROUND: The connection between diet, disease activity, and symptoms in inflammatory bowel disease (IBD) has received increasing attention. Although many studies explore associations between dietary patterns and IBD, there is limited understanding of patients' perspectives on dietary modifications and the challenges they encounter in implementing dietary changes. This scoping review aims to address this issue gap. AIM: To examine the existing evidence on adult IBD patients' perspectives on dietary modifications for symptom management and identify knowledge gaps for future research. METHODS: This scoping review followed the Joanna Briggs Institute (JBI) methodology. We searched MEDLINE (Ovid, from 1946) and Embase (Ovid, from 1974) until June 26, 2024. Qualitative, quantitative, and mixed-methods studies published in English that reported on IBD patients' perspectives, behaviors, and challenges regarding diet modification were included. Reference lists of relevant reviews were manually screened. No statistical comparisons were performed. RESULTS: The search identified 2909 studies, of which 53 met the inclusion criteria. Thirty-four studies focused primarily on patients' beliefs and behaviors regarding diet. Most IBD patients reported modifying their diet after diagnosis (56 %-91 %), most commonly through food avoidance (41-95 %) or by trialing restrictive diets to prevent relapse. Many patients believed diet played a role in IBD onset (8-49.2 %) and relapse prevention (33-74 %). Eighteen studies explored barriers to diet modification, the most commonly reported being negative impacts on social and family life and the unpredictability of dietary effects on overall health. Many patients sought dietary advice online. CONCLUSION: Food avoidance and social restrictions are common among IBD patients. While nutrition is believed to play a key role in IBD management, challenges in accessing professional dietary guidance persist. Further research is needed to explore difficulties in implementing dietary changes.