Irritable Bowel Syndrome (IBS) Nutritionists and Dietitians in Moore County, NC

Photo of Melissa Teel, Nutritionist/Dietitian, RD, LDN, MS
Melissa Teel
Nutritionist/Dietitian, RD, LDN, MS
Southern Pines, NC 28387
Some of my top specialties are digestion ( IBS, SIBO, Celiac, Ulcerative Colitis, Crohns), weight loss, diabetes (types 1, 2, & gestational), child feeding, Autism, prenatal & postnatal nutrition, breastfeeding, PCOS, menopause, & fertility nutrition.
Do you have a health challenge that you've struggled to overcome...even with medical help? Sometimes it seems like achieving great digestion, hormone balance, and high energy may be impossible to achieve...and that prospect can be daunting. As a Dietitian Nutritionist with additional expertise in Functional Medicine, I approach healthcare differently. I find and address root causes, provide individualized, realistic plans, and support you along your journey. The result is healthcare actually makes you healthier.
Some of my top specialties are digestion ( IBS, SIBO, Celiac, Ulcerative Colitis, Crohns), weight loss, diabetes (types 1, 2, & gestational), child feeding, Autism, prenatal & postnatal nutrition, breastfeeding, PCOS, menopause, & fertility nutrition.
Do you have a health challenge that you've struggled to overcome...even with medical help? Sometimes it seems like achieving great digestion, hormone balance, and high energy may be impossible to achieve...and that prospect can be daunting. As a Dietitian Nutritionist with additional expertise in Functional Medicine, I approach healthcare differently. I find and address root causes, provide individualized, realistic plans, and support you along your journey. The result is healthcare actually makes you healthier.
(910) 665-8543 View (910) 665-8543

Online Dietitians and Nutritionists

Photo of Christine Corcoran, Nutritionist/Dietitian, MS, RD, LDN
Christine Corcoran
Nutritionist/Dietitian, MS, RD, LDN
1 Endorsed
Charlotte, NC 28203
We know change is not easy. We know finding food freedom can sound scary (maybe even impossible). It is our mission to guide you through uncharted territory and give you the knowledge and support you need to make real and lasting changes. Our approach to health and nutrition is weight-inclusive, and will always focus on finding peace and balance with food and exercise. We are continuously educating ourselves to provide a safe and welcoming space for all individuals. We work to analyze eating habits together and make changes based on where you are.
We know change is not easy. We know finding food freedom can sound scary (maybe even impossible). It is our mission to guide you through uncharted territory and give you the knowledge and support you need to make real and lasting changes. Our approach to health and nutrition is weight-inclusive, and will always focus on finding peace and balance with food and exercise. We are continuously educating ourselves to provide a safe and welcoming space for all individuals. We work to analyze eating habits together and make changes based on where you are.
(704) 753-8712 View (704) 753-8712
Photo of Amanda Averett, Nutritionist/Dietitian, MS, RD, LDN
Amanda Averett
Nutritionist/Dietitian, MS, RD, LDN
Online Only
Welcome! I’m Amanda (she/her), one of the registered dietitians at Redefined Nutrition. I specialize in helping individuals with ADHD/Autism navigate the challenges they face with eating and nourishing their bodies, as it can often feel like one more thing to juggle. Distractions, sensory sensitivities, and inconsistent eating habits make things like meal planning and staying on track feel like a constant struggle. As a neurodivergent dietitian, I understand these challenges firsthand. Managing nutrition isn’t just about food—it’s about understanding how your unique brain works and finding ways to make eating less overwhelming.
Welcome! I’m Amanda (she/her), one of the registered dietitians at Redefined Nutrition. I specialize in helping individuals with ADHD/Autism navigate the challenges they face with eating and nourishing their bodies, as it can often feel like one more thing to juggle. Distractions, sensory sensitivities, and inconsistent eating habits make things like meal planning and staying on track feel like a constant struggle. As a neurodivergent dietitian, I understand these challenges firsthand. Managing nutrition isn’t just about food—it’s about understanding how your unique brain works and finding ways to make eating less overwhelming.
(980) 370-2839 View (980) 370-2839
Photo of Rachael A Richardson - Rachael Richardson, Nutritionist/Dietitian, RDN, LDN
Rachael Richardson
Nutritionist/Dietitian, RDN, LDN
1 Endorsed
Raleigh, NC 27609
For 25 years, I’ve helped people with complex medical conditions finally understand the root cause of their condition. Through nutrition education, counseling, targeted supplements, advanced labs, and holistic lifestyle strategies, I help uncover the root causes behind your symptoms and create a plan that actually works. Your body can heal and rebalance—you have more power than you’ve been told, and I’m here to guide you the whole way through!
For 25 years, I’ve helped people with complex medical conditions finally understand the root cause of their condition. Through nutrition education, counseling, targeted supplements, advanced labs, and holistic lifestyle strategies, I help uncover the root causes behind your symptoms and create a plan that actually works. Your body can heal and rebalance—you have more power than you’ve been told, and I’m here to guide you the whole way through!
(919) 420-3913 View (919) 420-3913
Photo of Rhya Pachin, Nutritionist/Dietitian, MS, RDN, LDN, CLT
Rhya Pachin
Nutritionist/Dietitian, MS, RDN, LDN, CLT
Online Only
My specialties and nutritional counseling interests include: infertility/pregnancy nutrition, eczema, IBS/IBD, autoimmune disease (Hashimoto's, RA, colitis), and food sensitivities/intolerances.
Looking for relief from chronic health conditions and a deeper level of nutritional support? Struggling to get answers? My focus is to identify and address the root cause of symptoms in order to help you achieve optimal health.
My specialties and nutritional counseling interests include: infertility/pregnancy nutrition, eczema, IBS/IBD, autoimmune disease (Hashimoto's, RA, colitis), and food sensitivities/intolerances.
Looking for relief from chronic health conditions and a deeper level of nutritional support? Struggling to get answers? My focus is to identify and address the root cause of symptoms in order to help you achieve optimal health.
(704) 761-7796 View (704) 761-7796
Photo of Jasmine Burroughs, Nutritionist/Dietitian, MS, RD, LDN
Jasmine Burroughs
Nutritionist/Dietitian, MS, RD, LDN
Durham, NC 27704
I am a plant-forward dietitian who loves to make healthy eating simple and satisfying. My counseling style is supportive, practical, and judgment-free. I know it can be difficult to make healthy choices while surrounded by convenience foods that are quick, affordable, and tasty - especially when healthy foods are associate higher costs, longer meal prep times, and a lack of flavor. That's why I take the time to truly listen and help you understand nutrition in a way that fits your life, culture, and health goals. My approach focuses on realistic changes, not perfection, so you can build habits that last.
I am a plant-forward dietitian who loves to make healthy eating simple and satisfying. My counseling style is supportive, practical, and judgment-free. I know it can be difficult to make healthy choices while surrounded by convenience foods that are quick, affordable, and tasty - especially when healthy foods are associate higher costs, longer meal prep times, and a lack of flavor. That's why I take the time to truly listen and help you understand nutrition in a way that fits your life, culture, and health goals. My approach focuses on realistic changes, not perfection, so you can build habits that last.
(919) 680-1722 View (919) 680-1722
Photo of Manju Karkare, Nutritionist/Dietitian, MS, RDN, LDN, CLT, FAND
Manju Karkare
Nutritionist/Dietitian, MS, RDN, LDN, CLT, FAND
1 Endorsed
Online Only
I am a Registered Dietitian with a breadth of experience for over 20 years. I have been licensed to practice dietetics in NC since 1999. I believe in providing evidence based, scientifically proven nutritional counseling. I have worked in a variety of capacities including acute care clinical nutrition, outpatient oncology (cancer care) consulting, public health education and classroom instruction. I am passionate about helping people learn about healthy eating and loving it.
I am a Registered Dietitian with a breadth of experience for over 20 years. I have been licensed to practice dietetics in NC since 1999. I believe in providing evidence based, scientifically proven nutritional counseling. I have worked in a variety of capacities including acute care clinical nutrition, outpatient oncology (cancer care) consulting, public health education and classroom instruction. I am passionate about helping people learn about healthy eating and loving it.
(919) 728-5995 View (919) 728-5995
Photo of Renee Galas, Nutritionist/Dietitian, RDN, LDN
Renee Galas
Nutritionist/Dietitian, RDN, LDN
Durham, NC 27701
Hi, I’m Renee — a passionate dietitian who believes that food is so much more than fuel. It’s connection, comfort, and one of the most powerful tools we have to support health and happiness. My journey into nutrition began with a deep curiosity about how what we eat shapes how we feel — physically, mentally, and emotionally. Over the years, I’ve worked with people from all walks of life, helping them cut through confusion, rebuild a healthy relationship with food, and find joy in nourishing themselves without restriction or guilt.
Hi, I’m Renee — a passionate dietitian who believes that food is so much more than fuel. It’s connection, comfort, and one of the most powerful tools we have to support health and happiness. My journey into nutrition began with a deep curiosity about how what we eat shapes how we feel — physically, mentally, and emotionally. Over the years, I’ve worked with people from all walks of life, helping them cut through confusion, rebuild a healthy relationship with food, and find joy in nourishing themselves without restriction or guilt.
(984) 367-4498 View (984) 367-4498
Photo of Courtney Walker, Nutritionist/Dietitian, MS, RDN, LDN
Courtney Walker
Nutritionist/Dietitian, MS, RDN, LDN
1 Endorsed
Charlotte, NC 28203
If you are struggling to develop a peaceful relationship with food, know that you are not alone. Confusing messages telling us how to eat, what to eat, and when to eat can make us wonder why eating has gotten so complicated. The short answer: it doesn't have to be. Whether you have been diagnosed with an eating disorder, suffer from disordered eating, or just want to know how to nourish your body without going on another diet, I can help.
If you are struggling to develop a peaceful relationship with food, know that you are not alone. Confusing messages telling us how to eat, what to eat, and when to eat can make us wonder why eating has gotten so complicated. The short answer: it doesn't have to be. Whether you have been diagnosed with an eating disorder, suffer from disordered eating, or just want to know how to nourish your body without going on another diet, I can help.
(704) 741-0356 View (704) 741-0356
Photo of Kendra Leanne Gaffney - Nutritious Thoughts, LLC, Nutritionist/Dietitian, RD, LDN, CEDS-C
Nutritious Thoughts, LLC
Nutritionist/Dietitian, RD, LDN, CEDS-C
Cary, NC 27511
We provide support around Eating Disorders, Eating Concerns, Embodiment, Nutrition for Substance Use Recovery, Nutrition for Mental Health, Nutrition for Competitive & Recreational Athletes, Chronic Health Concerns, and Gestational, Hormonal & Reproductive health. Nutritious Thoughts is a team of compassion-centered dietitians located in North Carolina and virtually across the nation! We practice under the philosophy that humans of all body sizes, shapes, & abilities are worthy of care. We strive to create an authentic human experience through connection & creating positive relationships with food.
We provide support around Eating Disorders, Eating Concerns, Embodiment, Nutrition for Substance Use Recovery, Nutrition for Mental Health, Nutrition for Competitive & Recreational Athletes, Chronic Health Concerns, and Gestational, Hormonal & Reproductive health. Nutritious Thoughts is a team of compassion-centered dietitians located in North Carolina and virtually across the nation! We practice under the philosophy that humans of all body sizes, shapes, & abilities are worthy of care. We strive to create an authentic human experience through connection & creating positive relationships with food.
(828) 348-5822 View (828) 348-5822
Photo of Kathryn Sayre, Nutritionist/Dietitian, MPH, RDN, LDN
Kathryn Sayre
Nutritionist/Dietitian, MPH, RDN, LDN
Durham, NC 27713
As a non-diet, Health at Every Size aligned dietitian, I enjoy working with individuals who want to better their lives through dietary and lifestyle changes. I've seen the positive effects of eating to nourish body and mind and the negative effects when clients are not meeting their nutrition needs. Working with clients to develop a plan to help meet their needs, often reducing physical and mental stress, is a passion of mine. We discuss individualized goals that work within the bounds of a person's lifestyle and preferences.
As a non-diet, Health at Every Size aligned dietitian, I enjoy working with individuals who want to better their lives through dietary and lifestyle changes. I've seen the positive effects of eating to nourish body and mind and the negative effects when clients are not meeting their nutrition needs. Working with clients to develop a plan to help meet their needs, often reducing physical and mental stress, is a passion of mine. We discuss individualized goals that work within the bounds of a person's lifestyle and preferences.
(973) 321-3698 View (973) 321-3698
Photo of Cheryl Buckley, Nutritionist/Dietitian, RDN, CDN, MBA , LDN, MS
Cheryl Buckley
Nutritionist/Dietitian, RDN, CDN, MBA , LDN, MS
Charlotte, NC 28210
I help individuals overcome dysfunction in their bodies from a holistic approach. I specifically target gut health, look at your lifestyle, nutrition, symptoms, and imbalances in your body, and create a personalized nutrition plan to help improve your overall well-being. Please visit my website for more information. Https://www.cherylbuckley.com
I help individuals overcome dysfunction in their bodies from a holistic approach. I specifically target gut health, look at your lifestyle, nutrition, symptoms, and imbalances in your body, and create a personalized nutrition plan to help improve your overall well-being. Please visit my website for more information. Https://www.cherylbuckley.com
(704) 665-0042 View (704) 665-0042
Photo of Rima Kleiner, Nutritionist/Dietitian, MS, RDN, LDN, IFNCP, CLT
Rima Kleiner
Nutritionist/Dietitian, MS, RDN, LDN, IFNCP, CLT
1 Endorsed
Online Only
As a functional and integrated Registered Dietitian-Nutritionist, I help busy people who are struggling with low energy, stubborn weight, bloating and other GI issues, food sensitivities and metabolic and hormone imbalances feel energized throughout the day, lose weight without dieting and, ultimately, live fully doing the things they love.
As a functional and integrated Registered Dietitian-Nutritionist, I help busy people who are struggling with low energy, stubborn weight, bloating and other GI issues, food sensitivities and metabolic and hormone imbalances feel energized throughout the day, lose weight without dieting and, ultimately, live fully doing the things they love.
(336) 814-9706 x1 View (336) 814-9706 x1
Photo of Peggy Smith, Nutritionist/Dietitian, RDN, LDN, CDE
Peggy Smith
Nutritionist/Dietitian, RDN, LDN, CDE
Clayton, NC 27520
I enjoy working with both individuals and groups to discover new ways to meet their goals, on topics including heart disease, diabetes, reducing inflammation, PCOS or uncovering the mysteries of the food label and the grocery store. I am determined to show others how easy it can be to incorporate whole foods in the processed environment in which we live. I know first hand how challenging meal planning and meal preparation can be especially with working full time and having two school aged children to balance the every day time restraints.
I enjoy working with both individuals and groups to discover new ways to meet their goals, on topics including heart disease, diabetes, reducing inflammation, PCOS or uncovering the mysteries of the food label and the grocery store. I am determined to show others how easy it can be to incorporate whole foods in the processed environment in which we live. I know first hand how challenging meal planning and meal preparation can be especially with working full time and having two school aged children to balance the every day time restraints.
(984) 409-9449 View (984) 409-9449
Photo of Gina Marie Gilchrist, Nutritionist/Dietitian, RD, LDN
Gina Marie Gilchrist
Nutritionist/Dietitian, RD, LDN
Charlotte, NC 28227
Gina Gilchrist is a Registered Dietitian with 24 years of experience in varied settings, including outpatient nutrition counseling, nutrition health coaching/private practice, research, and corporate health. Gina’s passion is counseling pediatric and adolescent patients and their families, however, she also enjoys and has experience working with adults and seniors. She loves to wear many hats and utilizes her creativity in the field as she has presented on various nutrition topics for colleagues, communities, and corporations. She enjoys writing and upheld a nutrition column in Silent Sports Magazine while residing in Chicago.
Gina Gilchrist is a Registered Dietitian with 24 years of experience in varied settings, including outpatient nutrition counseling, nutrition health coaching/private practice, research, and corporate health. Gina’s passion is counseling pediatric and adolescent patients and their families, however, she also enjoys and has experience working with adults and seniors. She loves to wear many hats and utilizes her creativity in the field as she has presented on various nutrition topics for colleagues, communities, and corporations. She enjoys writing and upheld a nutrition column in Silent Sports Magazine while residing in Chicago.
(704) 327-0257 View (704) 327-0257
Photo of Neika Dauphin - Sis Your Uterus Matters, Nutritionist/Dietitian, MPH, RD, LDN
Sis Your Uterus Matters
Nutritionist/Dietitian, MPH, RD, LDN
Online Only
I am a Registered Dietitian and current medical student with a deep passion for helping people feel better in their bodies physically and emotionally. I work with clients who feel overwhelmed by fatigue, hormone shifts, insulin resistance, bloating, inconsistent eating, or weight changes. Many are tired of extremes and just want clarity, structure, and support that actually fits their life. If you want to feel more in control of your health but need practical and compassionate guidance without pressure for perfection, I am here to help you create lasting and sustainable change.
I am a Registered Dietitian and current medical student with a deep passion for helping people feel better in their bodies physically and emotionally. I work with clients who feel overwhelmed by fatigue, hormone shifts, insulin resistance, bloating, inconsistent eating, or weight changes. Many are tired of extremes and just want clarity, structure, and support that actually fits their life. If you want to feel more in control of your health but need practical and compassionate guidance without pressure for perfection, I am here to help you create lasting and sustainable change.
(919) 804-1475 View (919) 804-1475
Photo of Willande Unelus, Nutritionist/Dietitian, MA, RD, LDN, CHN
Willande Unelus
Nutritionist/Dietitian, MA, RD, LDN, CHN
Online Only
I am a Registered Dietitian Nutritionist and Cultural Nutritionist who helps individuals and families improve their health while honoring their cultural foods and traditions. I provide compassionate, personalized nutrition counseling with a focus on food as medicine, chronic disease prevention and management, and building sustainable, realistic habits. I specialize in working with clients from multicultural communities who may not feel fully seen or understood in traditional healthcare settings. My approach is supportive, non-judgmental, and tailored to your lifestyle, not restrictive diets. I offer virtual services.
I am a Registered Dietitian Nutritionist and Cultural Nutritionist who helps individuals and families improve their health while honoring their cultural foods and traditions. I provide compassionate, personalized nutrition counseling with a focus on food as medicine, chronic disease prevention and management, and building sustainable, realistic habits. I specialize in working with clients from multicultural communities who may not feel fully seen or understood in traditional healthcare settings. My approach is supportive, non-judgmental, and tailored to your lifestyle, not restrictive diets. I offer virtual services.
(984) 223-5735 View (984) 223-5735
Photo of Emily Paeth, Nutritionist/Dietitian, MS, RDN, LDN
Emily Paeth
Nutritionist/Dietitian, MS, RDN, LDN
3 Endorsed
Charlotte, NC 28204
Specialties include Eating disorders, Disordered Eating, Digestive Issues, IBS, Crohn's, Celiac, PCOS, Intuitive Eating, Body Image Concerns, and Vegan/Vegetarian diets.
Emily practices out of Health Loft and specializes in working with Eating Disorders, Disordered Eating, Plant Based Diets, Digestive Issues, Body Image Concerns and other conditions. She strongly believes that all foods fit and strives to help clients in their food freedom journey. Using a weight neutral and non-judgemental approach, Emily believes that health is multifactorial and will work to see you as a person, rather than a diagnosis. Emily has spent the majority of her career in higher levels of care for eating disorder treatment (RES, PHP, IOP) treating various eating disorders diagnoses.
Specialties include Eating disorders, Disordered Eating, Digestive Issues, IBS, Crohn's, Celiac, PCOS, Intuitive Eating, Body Image Concerns, and Vegan/Vegetarian diets.
Emily practices out of Health Loft and specializes in working with Eating Disorders, Disordered Eating, Plant Based Diets, Digestive Issues, Body Image Concerns and other conditions. She strongly believes that all foods fit and strives to help clients in their food freedom journey. Using a weight neutral and non-judgemental approach, Emily believes that health is multifactorial and will work to see you as a person, rather than a diagnosis. Emily has spent the majority of her career in higher levels of care for eating disorder treatment (RES, PHP, IOP) treating various eating disorders diagnoses.
(754) 325-3311 View (754) 325-3311
Photo of Laura Greenhow Bransfield - Summerfield Custom Wellness, Nutritionist/Dietitian, MPH, RD, LDN
Summerfield Custom Wellness
Nutritionist/Dietitian, MPH, RD, LDN
Online Only
Summerfield Custom Wellness is a nutrition counseling practice of Registered Dietitians, specializing in the intersection of integrative, clinical, and functional approaches that take all aspects of lifestyle into consideration. Our team of 20 passionate Registered Dietitians have different overlapping and complementary specialties. This means that we can help almost anyone who contacts us whether it is for weight loss, relationship with food, digestive discomfort, chronic disease management, food allergies, or other special diets. Currently accepting new patients for virtual appointments (zoom), only.
Summerfield Custom Wellness is a nutrition counseling practice of Registered Dietitians, specializing in the intersection of integrative, clinical, and functional approaches that take all aspects of lifestyle into consideration. Our team of 20 passionate Registered Dietitians have different overlapping and complementary specialties. This means that we can help almost anyone who contacts us whether it is for weight loss, relationship with food, digestive discomfort, chronic disease management, food allergies, or other special diets. Currently accepting new patients for virtual appointments (zoom), only.
(910) 218-9283 View (910) 218-9283
Photo of Mary Beth Hynek - MB Hynek Nutrition, Nutritionist/Dietitian, MS, RD, LDN
MB Hynek Nutrition
Nutritionist/Dietitian, MS, RD, LDN
Winston Salem, NC 27106
My goal is to empower people to build healthy, balanced lifestyles while genuinely enjoying the foods they eat. I believe that nutrition is one of the most powerful tools for preventing disease and promoting lifelong wellness. Rather than focusing on restrictions, I emphasize the abundance of nourishing, delicious foods that can enhance both health and quality of life. My approach is centered on providing expert guidance and unwavering support, making the path to better health both achievable and sustainable.
My goal is to empower people to build healthy, balanced lifestyles while genuinely enjoying the foods they eat. I believe that nutrition is one of the most powerful tools for preventing disease and promoting lifelong wellness. Rather than focusing on restrictions, I emphasize the abundance of nourishing, delicious foods that can enhance both health and quality of life. My approach is centered on providing expert guidance and unwavering support, making the path to better health both achievable and sustainable.
(336) 360-6146 View (336) 360-6146
Irritable Bowel Syndrome (IBS) Nutritionists and Dietitians
What is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome (IBS) is a general term that refers to a collection of symptoms associated with poor gut mobility and function, including abdominal pain, bloating, gas, and diarrhea. IBS is very common, with some estimates suggesting that as many as 10-15% of adults within the United States have IBS. Although the two conditions sound similar and share many symptoms, such as abdominal pain and diarrhea, IBS differs from irritable bowel diseases (IBDs), such as ulcerative colitis and Crohn's disease. In contrast to IBS which is caused by issues in the functioning of the colon, IBDs are inflammatory conditions caused by overactive immune cells within the intestine. IBDs are much less common than IBS and typically more medically severe, occasionally requiring intensive medical treatment and/or surgery. IBS, in contrast, can usually be managed effectively with lifestyle changes and less intense medical intervention.

What are the subcategories of IBS?
Medical professionals generally identify four main types of IBS: IBS-C (constipation-predominant subtype), IBS-D (diarrhea-predominant subtype), IBS-M (mixed bowel subtype), and IBS-U (undefined subtype). Identifying the predominant type of IBS an individual has can be important for determining the type of treatment that is best for them, such as the lifestyle and dietary changes that may be most appropriate, as well as any medications that may be necessary. However, individuals may also experience multiple subtypes over time, as well as experience cycles of flare-ups and symptom relief.

What causes IBS?
The causes of IBS are not well understood, but symptoms are generally attributed to issues with gut muscle contraction and changes in the gut microbiome, both of which can lead to the characteristic symptoms of IBS. These issues can be caused by a variety of lifestyle factors, such as diet and stress. While lifestyle modifications may not completely cure IBS symptoms, identifying symptom-triggering foods, consuming a balanced diet, and reducing stress have all been shown to greatly reduce symptoms. IBS can also be caused by bacterial or parasitic infections within the intestine, in which case the syndrome is referred to as "post-infectious IBS." In contrast to non-infectious IBS, post-infectious IBS is less chronic in nature and symptoms will often resolve once the infection has subsided.

What foods should I avoid if I have IBS?
Specific foods that may trigger symptoms of IBS can vary person-to-person. However, common foods that may exacerbate symptoms include high-fat foods (such as fatty meats), wheat, dairy products, highly acidic foods (such as citrus), beans, cabbage, milk, and carbonated drinks. Over time, individuals with IBS are often able to identify which foods cause their symptoms to worsen and learn to avoid such foods to manage their symptoms.