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Trends in Inflammatory Bowel Disease Therapy 1999 pp 207–216Cite as

The role of nutrition in the treatment of inflammatory bowel disease

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Abstract

Nutritional management was seen as a possible therapeutic tool in imflammatory bowel disease (IBD) due to various clinical observations:

  1. 1

    The fact that some foodstuffs may act as antigen-triggering symptoms, especially in Crohn’s disease, which has prompted the use of exclusion diets. These have been shown to be of some use in a small percentage of patients. On the other hand, it has not been demonstrated that the reintroduction of the offending foods after a disease bout would induce disease relapse.

  2. 2

    Nutritional deficiencies (macronutrients, micronutrients), frequent in these patients, may favour disease self-perptuation, because of impairment of tissue repair and intestinal mucosal barrier, defective defence against free-radical damage and lipid peroxidation, as well as potential increase in mucosal dysplasia (folate). Although theoretically possible, there are no clinical trials showing the potential benefit of supplementing these patients with antioxidant micronutrients, either in inducing remission or in preventing relapse of the disease. However, this aspect merits proper investigation.

  3. 3

    Some common severe long-term complications, such as growth and sexual development failure(children and adolescents)and osteopenia(children and adults)are not only related to the disease itself or its treatment (steroids), but also strongly linked to the presence of malnutrition.

  4. 4

    Nutritional habits of some communities have been associated with low incidence of ulcerative colitis(UC)and Crohn’s disease (CD), suggesting that some components of these diets may favour a modulation of the inflammatory response. These have been postulated to be related to changes in lipid composition in the membranes of the immune-competent cells which, in turn, may influence eicosanoid and cytokine release.

  5. 5

    The insufficient amount of products of colonic metabolism of unabsorbed carbohydrates (butyrate) or its defective oxidation by colonocytes, has been related to the pathogenesis of UC and pouchitis.

  6. 6

    Enteral formula diets, used as a unique or partial daily nutrition source, have been used as primary therapy in CD as an alternative to steroids in an attempt to avoid its severe side-effects.

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  1. M. A. Gassull
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Editors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

    C. N. Williams

  2. Faculty of Medicine, The Health Sciences Centre, Memorial University of Newfoundland, St John’s, Newfoundland, Canada

    R. F. Bursey

  3. Faculty of Medicine, The University of Calgary, Alberta, Canada

    D. G. Gall , L. R. Sutherland  & J. L. Wallace ,  & 

  4. University of Montreal, Canada

    F. Martin

  5. Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

    R. S. McLeod

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Gassull, M.A. (2000). The role of nutrition in the treatment of inflammatory bowel disease. In: Williams, C.N., et al. Trends in Inflammatory Bowel Disease Therapy 1999. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4002-7_21

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