Diet in the Pathogenesis and Treatment of Inflammatory Bowel Diseases

Abstract

Some of the most common symptoms of the inflammatory bowel diseases (IBD, which include ulcerative colitis and Crohn’s disease) are abdominal pain, diarrhea, and weight loss. It is therefore not surprising that clinicians and patients have wondered whether dietary patterns influence the onset or course of IBD. The question of what to eat is among the most commonly asked by patients and among the most difficult to answer by clinicians. There are therefore substantial variations in dietary behaviors of patients and recommendations for them, although clinicians do not routinely endorse specific diets for patients with IBD. Dietary clinical trials have been limited by their inability to include a placebo control, contamination of study groups, and inclusion of patients receiving medical therapies. Further challenges include accuracy of information on dietary intake, complex interactions between foods consumed, and differences in food metabolism among individuals. We review the roles of diet in the etiology and management of IBD, based on plausible mechanisms and clinical evidence. Researchers have learned much about the effects of diet on the mucosal immune system, epithelial function, and the intestinal microbiome; these findings could have significant practical implications. Controlled studies of patients receiving enteral nutrition and observations made from patients on exclusion diets have shown that components of whole foods can have deleterious effects for patients with IBD. Additionally, studies in animal models suggested that certain nutrients can reduce intestinal inflammation. In the future, engineered diets that restrict deleterious components but supplement beneficial nutrients could be used to modify the luminal intestinal environment of patients with IBD—these might be used alone or in combination with immunosuppressive agents, or as salvage therapy for patients who do not respond or lose responsiveness to medical therapies. Stricter diets might be required to induce remission, whereas more sustainable exclusion diets could be used to maintain long-term remission.

Therapeutic Modulation of Gut Microbiota in Functional Bowel Disorders

“…In the future, engineered diets that restrict deleterious components but supplement beneficial nutrients can be used to modify the luminal intestinal environment for the treatment or prevention of diseases. 54 Human dietary-intervention studies in FBDs are scarce, however, because a dietary-intervention study has many limitations, such as the inability to use placebos as controls and the difficulty of accurately capturing the dietary intake. Many clinical studies on diets have been limited to specific nutrients and foods, but the interactions between the foods consumed, the proportion of food intake, and the effect of the food structure and/ or cooking practices should also be considered.…”

A bél–máj tengely vizsgálata colitis ulcerosában. Retrospektív tanulmány

“…Ezzel is csökkentve a szervezet antioxidáns védekezőképességét. A makrorostanyagok fogyasztása gyakran okoz kellemetlen panaszokat IBD-ben, így a betegek bizonyos ételeket kerülnek [7][8][9][10].…”

Modulation of Gut Microbiota by Maillard Reaction Products in Intestinal Inflammation: Are We What We Eat?

“…As an example, inflammatory bowel disease (IBD) possesses an established etiopathogenesis which comprises the genetic susceptibility and environmental factors associated with changes in the intestinal microbiota. The increasing incidence of IBD correlates with overall global industrialization, which in turn correlates with the ''Western pattern diet'' [1].…”