Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease

In our clinics we suggest that an attempt to liberalization should occur preferably after the disease is well controlled and is in the inactive phase

Samir Kakodkar; Ece A. Mutlu

2017

Scholarcy highlights

  • There is suspicion that the pathogenesis of inflammatory bowel disease may involve the Western diet that is known to be high in fat, n-6 PUFA and red and processed meat and low in fruits and vegetables
  • Many patients are informed that diet likely does not play any part in the development or perpetuation of inflammation, and there is no one particular diet that has been shown to be definitely effective in treating IBD
  • This review will predominantly focus on exclusive enteral nutrition, which has the most robust evidence to support its use for the induction of remission in Crohn’s disease, and the Specific Carbohydrate Diet, which perhaps already has the largest following amongst IBD patients and has some preliminary evidence published to support its efficacy
  • This suggests that SCD is a starting point for IBD patients to explore their individual diet-disease relationship especially in the maintenance phase; and that patients could potentially conduct trial and error experiments on themselves with the aid of a health provider who can give objective dietary and clinical advice and can follow how they respond with preferably with objective assessments
  • The theory behind the low FODMAP diet is partially similar to that of the SCD in that it tries to exclude poorly absorbed short-chain carbohydrates, that can be fermented by intestinal bacteria resulting in gas and bloating, abdominal pain and change In bowel habits
  • “Eat what you can tolerate.”. Despite this refrain, approximately 40% of patients with Crohn’s disease believe that diet can control symptoms while approximately 80% believe diet is important in the overall management of disease
  • The results demonstrated that this “anti-IBD” diet resulted in a reduction of the flares compared to placebo and an FOS supplement, with a moderate effect size; quality of life did not decline with the interventions; and beneficial bacteria such as Roseburia increased at the end of treatment
  • The low FODMAP diet focuses on excluding particular carbohydrates, is less restrictive and may be appropriate in inflammatory bowel disease patients without active disease to decrease IBS-like symptoms

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