Dietary management of disorders of gut-brain interaction (DGBI): practical guidance for gastroenterologists

Disorders of gut-brain interaction (DGBI) are common chronic gastrointestinal conditions diagnosed using the Rome V criteria. They account for a substantial proportion of gastroenterology workload, with many patients identifying specific foods as symptom triggers. Dietary management is therefore a frequent focus of care, and an emerging evidence base supports a broad range of dietary interventions that can provide meaningful symptom improvement when matched to patients symptom profile. However, readiness for dietary change and psychosocial contexts must be considered to facilitate optimal outcomes. This is important as, for a subset of patients, dietary therapies may exacerbate avoidant or disordered eating, highlighting the rationale for screening for these risks before implementing restrictive modalities, such as the low-fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet. This review presents a pragmatic framework for gastroenterologists, highlighting clinical considerations when implementing first-line dietary advice or referring to a dietitian for more complex dietary modalities. It summarises the spectrum of evidence-based dietary approaches for DGBI and provides practical resources to assist in safe and effective clinical use.