Experiences and Perceptions of Food Avoidance in Patients With Inflammatory Bowel Disease: A Qualitative Meta-Synthesis.

Background: Food avoidance, common in patients with inflammatory bowel disease (IBD), impacts their recovery and psychological health. However, limited insight is provided in the literature regarding the food avoidance experiences and perceptions of patients. A systematic qualitative synthesis exploring these experiences and perceptions may be expected to enhance scholarly understanding of their implications for IBD.

Purpose: This study was developed to review and characterize existing qualitative studies on food avoidance in patients with IBD and to use relevant data from previous studies to guide and optimize diet management strategies for patients.

Methods: Eight databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, and three Chinese databases) were searched to identify qualitative studies on the food avoidance experiences and perspectives of patients with IBD. Critical Appraisal Skills Program (CASP) Qualitative Checklists were applied to appraise the included studies, and a meta-synthesis approach was used to analyze the data. The findings and quotations from the studies were recharacterized into new themes and categories using inductive thematic synthesis and reciprocal interpretation.

Results: Of the 1,224 studies retrieved, 19 were included in this meta-synthesis. The experiences and feelings of food avoidance in patients with IBD included the four categories of Coping Strategies, Disruption of Life and Mood, Needs and Expectations, and Social Alienation, from which the following eleven themes were derived: (a) motivations and perspectives, (b) safe recipes updated in failure, (c) positive impact, (d) reshaping life planning and increasing life stress, (e) negative emotional challenges, (f) the role of family and friends in dietary management, (g) workplace support deficiencies, (h) lack of professional dietary guidelines, (i) alienation from intimacy, (j) alienation of culinary culture, and (k) social distancing.

Conclusions/implications for practice: The findings of this study highlight the complexities that underlie food avoidance behaviors in people with IBD and reveal the challenges faced by patients in managing their diet and emotions. The importance of personalized dietary guidance based on food avoidance, negative emotion de-escalation, and strong social support for disease management is highlighted.