Mobile e-Health dietary fiber calculator for self-management of IBS

DESCRIPTION (provided by applicant): Using conservative criteria it is estimated that 7 percent of the population in North America and 7-10 percent worldwide have Irritable Bowel Syndrome (IBS), a relapsing functional bowel disorder with unclear etiology.Disabling symptoms of IBS account for a significant amount of lost functionality, lost productivity, lowered perceived quality of life, and increased use of primary and specialty health care. Therapeutic approaches rely heavily on self-management of symptoms through an individualized array of pharmacological and non-pharmacological remedies, including an emphasis on assessing and adjusting dietary fiber intake to regulate bowel function and reduce pain. Several reviews have concluded that soluble fiber maybe more effective than insoluble fiber for constipation, and insoluble fiber may worsen some symptoms. IBS patients who attempt to monitor and regulate their intake of soluble and insoluble dietary fiber face challenges in correctly estimating their intake, including: a lack of consistent food labeling describing soluble and insoluble dietary fiber content (an optional descriptor); a lack of knowledge of dietary fiber content of unpackaged or unlabeled food; and a need to estimate collective dietary fiber contributions of all meal components and fiber supplements. Given the growth in use of handheld mobile devices with online capacity as well as the successful development and use of portable devices for self-management of other chronic health conditions, wepropose to develop a mobile Web- based application that enables IBS patients to quickly and accurately estimate soluble and insoluble dietary fiber content of foods or fiber supplements before consumption. The software also will enable real-time data collection on dietary fiber and fluid intake as well as IBS symptoms, which can be used by patients and their dietitians or other health care providers to inform dietary decision making. Currently available mobile dietary calculators do not employ food composition databases that distinguish between soluble and insoluble fiber and do not possess specific self-monitoring features that could be useful for IBS patients. An alpha version of the software will be developed in collaboration with 6-10 IBS patients and their dietitian utilizing a user-centered design approach, beginning with a focused self-management needs assessment followed by two rounds of iterative usability testing and revision. This application is in response to PA-11-096, Omnibus Solicitation of theNIH for Small Business Innovation Research Grant Applications (Parent SBIR [R43]) and is aligned with the NIDDK goal of developing new technologies and behavioral strategies to effectively treat functional GI and motility disorders and the NINR goal of generating new technologies to improve self-management. PUBLIC HEALTH RELEVANCE: It is conservatively estimated that 7 percent of the population in North America and 7-10 percent worldwide have Irritable Bowel Syndrome (IBS), a relapsing functionalbowel disorder with unclear etiology. Disabling symptoms of IBS account for a significant amount of lost functionality, lost productivity, lowered perceived quality of life, and increased use of health care services. Therapeutic approaches rely heavily onself- management of symptoms, including an emphasis on assessing and adjusting dietary fiber intake to regulate bowel function and reduce pain. Several reviews have concluded that soluble fiber may be more effective than insoluble fiber for constipation symptoms, and insoluble fiber may worsen some symptoms. IBS patients who attempt to monitor and regulate their intake of soluble and insoluble dietary fiber face challenges in correctly estimating their intake, including a lack of consistent food labeling describing soluble and insoluble dietary fiber content (an optional descriptor). Given the growth in use of handheld mobile devices with online capacity as well as the successful development and use of portable devices for self-management of other chronic health conditions, we propose to develop a mobile Web-based application that enables IBS patients to quickly and accurately estimate soluble and insoluble dietary fiber content of foods before consumption. The software also will enable real-time data collection on dietary fiber and fluid intake as well as IBS symptoms, which can be used by patients and their dietitians or other health care providers to inform dietary decision making. If the aims of this Phase I development project and a subsequent Phase II field test are achieved, patients and their providers would have an accessible and valid tool to support dietary self-management of IBS symptoms.