Bakgrund Virtuell vård innefattar alla digitala vårdlösningar exempelvis telefon, video och chatt och kräver därmed inga fysiska möten. Genom att med hjälp av virtuell vård behandla mindre akuta fall, såsom patienter med Irritable bowle syndrome (IBS), skulle den fysiska vården kunna avlastas och tid och pengar kunna sparas. Syfte Att undersöka uppfattningen av virtuell vård som kostbehandlingsmetod hos individer som genomgår kostbehandlingen FODMAP. Metod I samarbete med företaget Belly Balance skickades en webbaserad enkät ut till företagets medlemmar som genomgick eller hade genomgått företagets virtuella behandlingsprogram Magbalans. De inhämtade svaren (n=47) analyserades i SPSS och testades med hjälp av Fischers Exact Test. Signifikansnivån sattes till p ≤ 0,05. Resultat Några av orsakerna till att deltagarna sökt sig till virtuell vård var upplevd bristande hjälp från den fysiska vården samt smärta och obehag från mag-tarmkanalen. Deltagarna var positiva till virtuell vård och friheten att kunna genomföra behandlingen när och där man ville uppgavs vara en fördel. Merparten av deltagarna upplevde sig hjälpta av behandlingen, de yngre deltagarna i studien (< 47 år) upplevde i högre utsträckning att de blivit hjälpta i form av bättre maghälsa än de äldre deltagarna (≥ 47 år) (p=0,119). Vid utformning av virtuell vård visade studien att ingen hänsyn behöver tas till faktorer såsom ålder och utbildning. Slutsats Deltagarna i studien hade överlag en positiv inställning till och upplevde symtomlindring av virtuell vård som kostbehandlingsmetod, vilket skulle kunna göra den till en framtida aktuell behandlingsmetod för individer med IBS. Då tekniken är under konstant utveckling behövs fler studier, med utgångsläget av dagens tillgång på virtuella verktyg, göras för att kunna dra generaliserbara slutsatser för hur den virtuella vården i framtiden bör utformas. / Background Virtual care includes all digital care solutions such as phone, video, and chat. Therefore, virtual care does not require physical meetings. By using virtual care in the treatment of less acute cases, such as patients with Irritable bowel syndrome (IBS), the need for physical meetings would be reduced and time and money could be saved. Objective To investigate the perception of virtual care as the dietary treatment method for individuals undergoing the dietary treatment FODMAP. Method(s) In collaboration with the company Belly Balance, a web-based survey was sent to the companys’ members who underwent or had previously taken part of the companys’ virtual treatment program Magbalans. The obtained responses (n = 47) were analysed in SPSS and tested using Fischers Exact Test. The level of significance was p ≤ 0.05. Results Reasons why the participants requested virtual care were insufficient help from the regular care and pain and discomfort from the gastrointestinal tract. The participants were overall satisfied with the virtual treatment and the freedom to perform the treatment when and where they wanted to was highlighted as positive. Most participants were helped by the treatment, younger participants (< 47 years) perceived to a greater extent that they were helped than the older participants (≥ 47 years). The study showed that no consideration has to be taken for factors such as age and education when planning virtual care. Conclusion The participants in the study had a positive attitude towards and a good effect from the virtual FODMAP dietary treatment. This implies that this treatment approach to a greater extent should be used for individuals with IBS. As the technology is under constant development, more studies, based on today's access to virtual tools, are needed to be able to make generalizable conclusions about how virtual care should be developed in the future.

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abstract: Introduction: A diet high in fermented, oligio-, di-, monosaccharide, and polyols (FODMAP) has been shown to exacerbate symptoms of irritable bowel syndrome (IBS). Previous literature has shown significant improvement in IBS symptoms after adherence to a low FODMAP diet (LFD). However, dietary adherence to the LFD is difficult with patients stating that information provided by healthcare providers (HCPs) is generalized and nonspecific requiring them to search for supplementary information to fit their needs. Notably, studies that have used a combination of online and in-person methods for treatment have shown improved adherence to the LFD. Objective: To determine whether a novel artificial intelligence (AI) dietary mobile application will improve adherence to the LFD compared to a standard online dietary intervention (CON) in populations with IBS or IBS-like symptoms over a 4- week period. Methods: Participants were randomized into two groups: APP or CON. The intervention group was provided access to an AI mobile application, a dietary resource verified by registered dietitians which uses artificial intelligence to individualize dietary guidance in real-time with the ability to scan menus and barcodes and provide individuals with food scores based on their dietary preferences. Primary measures included mobile app engagement, dietary adherence, and manifestation of IBS-like symptoms. Baseline Results: A total of 58 participants were randomized to groups. This is an ongoing study and this thesis details the methodology and baseline characteristics of the participants at baseline and intervention start. Validation of the application could improve the range of offerings for lifestyle diseases treatable through dietary modification. / Dissertation/Thesis / Masters Thesis Nutrition 2020

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Irritable bowel syndrome (IBS) is a functional bowel disorder with 6.5% worldwide prevalence that causes gas production, abdominal distension, and abdominal pain or discomfort. This systematic review describes efficacy of the Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols (FODMAP) diet (Low-FODMAP diet or LFD) to alleviate IBS symptoms using the PRISMA guidelines. Nine randomized controlled trials (RCT) and one non-RCT consecutive controlled study published between 2015 to 2019 were identified using PubMed and CENTRAL. Included studies involved adult IBS participants with symptoms of abdominal pain, constipation, and/or diarrhea. A total of 530 participants completed the interventions from the 10 studies included in the final systematic review with participants ranging from mean ages of 40.31±12.83 years. The LFD can be recommended to patients for its use with alleviating abdominal pain severity and quality of life; however, more research is needed to verify the efficacy of the LFD concerning stool frequency and consistency.

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Bakgrund: Irritabel tjocktarm (IBS) är en funktionell tarmsjukdom med okänd etiologi. De typiska symtomen är obehag och/eller smärta vid tarmtömning, obehagliga gaser eller ändrad avföringskonsistens. Diagnostiken utgår från diagnoskriterier (Rom IV-kriterier). Behandlingsmetoder innefattar förändringar i livsstils- och kostvanor, kognitiv beteendeterapi samt läkemedelsbehandling och egenvårdsstrategier. Allmänsjuksköterskans roll är att lyssna, stötta och bekräfta den drabbade patienten i sitt lidande. Syfte: Syftet var att undersöka patienters upplevelser av att leva med IBS. Metod: En systematisk litteraturöversikt med induktiv ansats. Studien bygger på tio stycken kvalitativa originalartiklar som analyserades genom metasyntes, inspirerad av Friberg. Resultat:  I resultatet identifierades tre teman med sex tillhörande subteman. Temat upplevelse av att möta vården beskriver patientens negativa och positiva upplevelser av att möta vården samt upplevelser av sin egenvårdsbehandling. Temat känslor kring IBS beskriver patienternas fysiska och psykiska smärtor samt deras stunder av lättnad. Temat IBS inverkan på sociala relationer beskriver sjukdomens påverkan på den intima relationen/familjen samt på arbetslivet/vänner. Slutsats: Patienter upplever frustration till följd av ett negativt bemötande från sjukvården. Det finns stunder av lättnad och välbefinnande när patienten upplever symtomfrihet. Ett stort lidande skapas till följd av IBS symtomen, vilket även har en inverkan på patientens sociala relationer. Allmänsjuksköterskan bör i sin yrkesroll skapa och upprätthålla en vårdande relation för att öka patientens hälsa och minska lidande.

Introduction : Le syndrome de l’intestin irritable (SII) est un désordre gastro-intestinal qui atteint environ 15% de la population mondiale. La diète FODMAP (Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols), fractionnée en trois phases (élimination, réintroduction, personnalisation), a été développée pour établir une tolérance personnelle aux nutriments (glucides) qui accentuent les symptômes. Une approche a été créée avec la plateforme web SOSCuisine.com afin de permettre aux gens atteints du SII de suivre la diète FODMAP dans un contexte de libre-service. Celle-ci combine un service en ligne de menus hebdomadaires personnalisés faibles en FODMAP avec des instructions pour chaque étape de la diète et l'accès à un groupe de soutien par les pairs modéré par une nutritionniste spécialisée. Objectif : Évaluer l’impact de ce service sur la qualité de vie et le contrôle des symptômes physiologiques et psychologiques des gens atteints du SII. Méthode : Étude prospective observationnelle effectuée auprès de patients (suivis dans deux hôpitaux montréalais) souffrant du SII. Ceux-ci devaient effectuer la diète FODMAP via la plateforme web et des questionnaires leur ont été administrés en ligne avant et après les deux premières phases. Résultats : 35 personnes ont été incluses et 14 ont complété l’étude. Après l’intervention, la sévérité du SII et l’anxiété situationnelle des participants étaient significativement améliorées tandis que la qualité de vie demeurait inchangée. Conclusion : Cette étude pilote démontrent la pertinence et l’utilité de l’enseignement de la diète FODMAP à l’aide de méthodes alternatives. Cependant, des études de plus grande envergure sont nécessaires pour confirmer ces résultats. / Introduction: Irritable Bowel Syndrome (IBS) is a gastrointestinal disorder that affects approximately 15% of the worldwide population. The Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols (FODMAP) diet was developed to establish a personal tolerance to these nutrients (carbohydrates) that accentuate the symptoms related to IBS. This diet, lasting on average twelve weeks, is separated into three steps: elimination, reintroduction and personalization. An innovative approach has been developed by the online platform SOSCuisine.com to allow people with IBS to safely follow the FODMAP diet in a ‘self-service’ way. It combines an online service of personalized low-FODMAP weekly menus with instructions for each step of the diet in combination with an access to a peer support group moderated by a specialized registered dietitian. Objective: Assess the impact of this service on the quality of life and the control of physiological and psychological symptoms of people with IBS. Method: Prospective observational study involving patients (followed in two Montreal hospitals) suffering from IBS. They had to perform the FODMAP diet via the web platform and several variables were evaluated, via questionnaires administered online, before and after phase one and. Results: 35 people were included and 14 completed the study. After the intervention, the severity of the IBS and the situational anxiety of the participants were significantly improved while the quality of life was not changed. Conclusion: The data from this pilot study demonstrate the relevance and utility of teaching the FODMAP diet using alternative methods. However, larger studies are needed to confirm these results.

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