Lack of IBD Nutrition Support Led Me to Become a Dietitian | Emily Matson’s Story
Trellus Health Care Team Dietitian
It’s becoming increasingly apparent that multidisciplinary team care is key to treating inflammatory bowel disease. By addressing inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) in a more integrated way, not only are symptoms decreased but the overall quality of life is improved for the patient.
As a Registered Dietitian Nutritionist (RDN) I may be biased but including an RDN in the care team is an essential — but unfortunately uncommon practice — in many practices.
The role of nutrition care in IBD has not been well-recognized
This shift in the management of IBD has come a long way since I was first diagnosed with ulcerative colitis (UC) in 1998. I was newly 13 years old when I started experiencing symptoms of pain, bleeding, and diarrhea. For the next few years (yes, years), I tried many medications with no real improvement (except for steroids which I was on for much longer than I probably should have been).
During this time, my gastroenterologist was the only person on my “team”. The only nutritional counseling I received was using the BRAT diet when I was having diarrhea (a dietary approach that is no longer recommended). I was told “diet doesn’t matter,” so I continued eating a Standard American Diet (SAD, at apt acronym) — high sugar, highly processed foods, low fruits, and veggies.
My symptoms never improved (biologics for ulcerative colitis were still waiting for FDA approval), and when I was 17, my doctor found precancerous cells during a colonoscopy. My choices were presented harshly, either I can have my large intestine removed or I’ll probably have colon cancer within 2 years.
Before I turned 18, I had major surgery to take out my colon, a j-pouch formed, and a temporary ileostomy to use while the j-pouch healed. The only nutrition counseling I can remember receiving at this time was when the ostomy nurse told me to eat potato chips as a snack to encourage me to drink more water.
Eventually, my ileostomy was reversed, and I spent the next few years getting used to my new J-pouch. I still experienced some symptoms of diarrhea and pain, but at this point I was no longer on my parent’s health insurance plan. Since this timeframe was before the Affordable Care Act, I could not purchase individual health insurance since my IBD was considered a pre-existing condition (so no plan would cover me).
I also did not have a job that provided group health insurance. Without health insurance, I could not afford to pay for medical appointments out of pocket and did my best to manage my symptoms on my own.
Without nutritional guidance, I resorted to the “kitchen sink” approach
Over the years I cycled through many types of diets that were suggested online for IBD. Many of these were very restrictive, eliminating multiple foods or entire food groups, and ultimately created a lot of anxiety around food for me. Sometimes it seemed like they may have helped with symptoms, but I could never pinpoint which foods were helpful.
During this time, like many people, I also spent a lot of money on various supplements hoping something would help. Luckily, I suffered no ill effects from these other than wasting my time and money.
Once I had health insurance again, after 2 years, I was able to see a gastroenterologist who changed my diagnosis to Crohn’s disease and started me on a biologic. I also discovered I was deficient in iron and vitamin B12, most likely the result of restrictive diets coupled with IBD symptoms.
I finally had some significant improvement in my symptoms, so I allowed a broader range of foods back into my diet. My big takeaway from my diet experiments was incorporating more whole foods into my diet and limiting processed foods seemed to produce the best and most consistent results.
As an RDN, I help others avoid the IBD diet pitfalls I fell into
My interest in pursuing a career in nutrition came after the realization that my situation was not particularly unique. Referrals to dietitians seemed to be reserved for when you needed enteral nutrition, but it wasn’t typically recommended before you got to that critical point.
During my education and training, I was finally able to find what works best for me, nutritionally speaking, during both IBD flares and remission. I was also able to develop a healthier relationship with food, something I struggled with for a long time.
When you have IBD, personalized nutrition counseling with an IBD dietitian is a key component of your care plan. RDs (Registered Dietitians) provide evidence-based nutrition, help prevent and resolve nutrient deficiencies, and can guide you in identifying personal food triggers that may cause symptoms.
My journey with having IBD made me realize how important multidisciplinary care is not only for personalized disease management, but that the patient also needs to be included as part of the team that makes health care decisions. At Trellus Health, I’m able to be part of a healthcare team that can support patients taking an active role in their disease management.
About the Author
Emily Matson is a Registered Dietitian Nutritionist (RD) and Certified Diabetes Care and Education Specialist (CDCES). She received her Bachelor of Science in biology from the Western Washington University, where she worked in the research lab of Dr. Sandra Schulze, PhD, and completed her Master of Science in nutrition at Bastyr University.
Emily completed a postgraduate dietetic internship at the University of Michigan School of Public Health, raked 4th in the nation by US News & World Report, and holds professional memberships with the Academy of Nutrition and Dietetics (AND) and the Dietitians in Medical Nutrition Therapy Dietetic Practice Group (DMNT-DPG).
Throughout her career, Emily has worked both in-person and via digital telehealth platforms with clients from diverse cultural and health backgrounds — people with diabetes, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), hyperlipidemia, hypertension, and provided pediatric and general wellness counseling. Before joining Trellus Health, she worked as the Clinical Support Manager for Brook Health and as a Registered Dietitian at Dandelion Nutrition.
Her role as an educator extends beyond the patient. Emily has presented to health care managers, professors, doctors, dietetic students, and delivered conference talks. She continues to work as a teaching assistant at Bastyr University, helping educate the next generation of dietitians.