{"paper_id":"c4ac3919-c8bc-41f7-8bd3-eb4f0ea13607","body_text":"Summer Conference 2023, 3 –6 July 2023, Nutrition at key stages of the lifecycle\nSelf-managed dietary changes and gut symptoms in endometriosis: a\nqualitative interview study\nKomal Deepak Kumar 1,2 and Kate Maslin 2\n1Epsom & St. Helier University Hospitals NHS Trust, Sutton, UK and\n2University of Plymouth, Plymouth, UK\nEndometriosis is a chronic gynaecological condition characterised by the growth of endometrial lining outside the uterus leading to\nsymptoms such as pain and functional gut symptoms. This can have a profound impact on their quality of life. The prevalence can\nrange from 2–10% of the general population, however, is seen as up to 50% amongst those with infertility; it can be said that the exact\nprevalence is unknown(1). Currently, there is no cure for endometriosis. It is primarily managed with surgery, analgesia and hormonal\nmedication; research suggests dietary changes may effectively reduce pain and recurrence of gut symptoms, especially in those with\ncoexisting irritable bowel syndrome\n(2,3). However, endometriosis guidelines do not formally endorse dietary changes, and little is\nknown about how they are self-managed. Thereby, the objective of this study is to undertake semi-structured interviews to understand\nnutritional practices and management of gut symptoms in people with endometriosis in the UK.\nParticipants were recruited as part of a larger survey study (4) via endometriosis support groups on social media in August 2021.\nEligibility criteria were: a self-reported physician-led diagnosis of endometriosis, over 18 years old and residing in the UK.\nSemi-structured interviews were undertaken virtually via Zoom. A prede fined interview guide was developed based on previous lit-\nerature and the results of our group ’s survey\n(4). All interviews were transcribed and analysed using thematic analysis. Ethical approval\nwas obtained from the University of Plymouth (ref. 2809).\n10 participants were interviewed. All had made individual dietary changes to manage their gut-related endometriosis symptoms.\nDietary changes were made based on advice from social media support, books, websites or professionals other than dietitians.\nChanges included the restriction and exclusion of multiple essential food groups, including dairy, grains, vegetables, fruits, and animal\nproducts. These changes impacted participants ’ weight, nutritional status and relationship with food. Four strong themes emerged\nfrom the analysis:\n1) their life shaped by pain and symptoms\n2) lack of being taken seriously\n3) their attempts to self-manage dietary symptoms\n4) lack of dietetic intervention\nOverall the long delay waiting for a diagnosis, surgery\nand, at times, the re-occurrence of symptoms post- sur-\ngery led to unsupported trial and error with modi fiable\nlifestyle factors, including diet.\nOverall, participants demonstrated some patterns of restrictive eating behaviour and wanted more professional support to help\nmanage their endometriosis-related gut symptoms. This concurs with our previous research (4) , highlighting the need for dietitians\nto be involved in endometriosis care to help alleviate gut symptoms whilst ensuring nutritional adequacy and weight management\nfor women with endometriosis in different life stages ranging from puberty onwards, with symptoms extending beyond menopause\nin some cases.\nReferences\n1. Hickey M, Ballard K & Farquhar C (2014) BMJ 348, 1752.\n2. Huijs & Nap (2020) Reproductive Biomedicine 41(2), 317 –28.\n3. Moore (2017) Aust N Z J Obstet Gynaecol 57(2), 201 –05.\n4. Kumar D (2023) J Hum Nutr Diet PMID , 36794746.\nProceedings of the Nutrition Society (2023), 82 (OCE5) , E295 doi:10.1017/S0029665123003944\nProceedings of the Nutrition Society\nhttps://doi.org/10.1017/S0029665123003944 Published online by Cambridge University Press","source_license":"CC0","license_restricted":false}