Intestinal Ultrasound Adds Diagnostic Value and Safety to a Dietitian‐Led Clinic for Disorders of Gut–Brain Interaction

ABSTRACT Background Disorders of gut–brain interaction (DGBI) affect approximately 40% of the global population. Multidisciplinary models incorporating dietetic management are increasingly used, yet objective assessment tools remain limited. This study evaluated the clinical utility of intestinal ultrasound (IUS) within a dietitian‐led DGBI clinic. Methods Consecutive patients underwent IUS at baseline and after dietetic intervention. Irritable bowel syndrome severity scores (IBS‐SSS) and sonographic parameters were recorded at both visits. Fecal loading was defined by posterior acoustic shadowing and/or colonic diameter > 50 mm. Patient satisfaction was assessed using a 100‐point Visual Analog Scale (VAS), with scores ≥ 75 indicating satisfaction. Results Ninety‐seven patients underwent IUS: 85 met Rome IV criteria for irritable bowel syndrome, 7 for functional constipation, and 5 for functional diarrhea. IUS confirmed the clinical diagnosis in 67% (65/97) and led to management changes in 28% (27/97). Fecal loading was identified in 22% (6/27) of patients reporting diarrhea. Mean satisfaction with IUS was high (97; 95% CI: 87.5–100). Sequential IUS was performed in 38 patients; management of IUS‐defined fecal loading significantly reduced colonic diameter ( p < 0.001) and posterior acoustic shadowing ( p < 0.001), with corresponding improvement in IBS‐SSS scores ( p < 0.0001). New inflammatory bowel disease was detected in 3 (8%) patients. Conclusion IUS enhances diagnostic confidence and informs management in a dietitian‐led DGBI clinic. It represents a safe, well‐tolerated, and cost‐effective adjunct to clinical assessment, supporting its integration into multidisciplinary models of care. Further studies should clarify its role in functional gastrointestinal evaluation.