Diets in Inflammatory Bowel Diseases

Abstract

Introduction.

Inflammatory bowel diseases (IBD) are Crohn’s disease (CD) and Ulcerative Colitis (UC). Current therapies are based on classical pharmacotherapy, biological treatment and surgical interventions. In pediatric population with IBD diet plays an important role in clinical remission. In recent years the role of environmental component is becoming increasingly investigated topic.¹ 1 It is considered that diet and microbiome are one of main factors that induce process of inflammation.

 Aim.

Aim of this paper is to review the literature on dietary interventions in Inflammatory Bowel Diseases (IBD), focusing on its efficacy in inducing remission of inflammatory markers and improvement of patients symptoms.

Results.

The analysis of 19 studies confirms that Crohn’s disease Exclusion Diet (CDEC) with Partial Enteral Nutrition (PEN) is equivalently efficacious to Exclusive Enteral Nutrition (EEN) in inducing remission in pediatric CD with significantly higher patient’s adherence.  Head-to-head comparisons showed no clinical or biochemical superiority of the Specific Carbohydrate Diet (SCD) over the Mediterranean Diet (MD).  The Low-FODMAP diet (LFD) effectively reduced functional symptoms, but failed to lower inflammatory markers such as fecal calprotectin.

Conclusions.

Diet is a potent tool in inducing and maintaining IBD remission. Nutritional therapy has evolved from supportive care to primary treatment modality. CDEC+PEN is a preferred option in inducing remission in pediatric population with CD. In maintenance therapy diet such as MD should be prioritized over restrictive elimination diets (SCD).  The LFD should be used only for symptomatic relief. Future research comparing head-to-head nutritional interventions would be needed to draw more conclusions.