Nutrition in Pelvic Radiation Disease and Inflammatory Bowel Disease: Similarities and Differences

Abstract

Due to the intestinal inflammation, tissue damage, and painful abdominal symptoms restricting dietary intake associated with both diseases, patients with intestinal pelvic radiation disease (PRD) or inflammatory bowel disease (IBD) are at increased risk to develop protein calorie malnutrition and micronutrient deficiencies. In the current paper, we review the nutritional management of both diseases, listing the similar approaches of nutritional management and the nutritional implications of intestinal dysfunction of both diseases. Malnutrition is prevalent in patients with either disease and nutritional risk screening and assessment of nutritional status are required for designing the proper nutritional intervention plan. This plan may include dietary management, oral nutritional supplementation, and enteral and/or parenteral nutrition. In addition to managing malnutrition, nutrients exert immune modulating effects during periods of intestinal inflammation and can play a role in mitigating the risks associated with the disease activity. Consistently, exclusive enteral feeding is recommended for inducing remission in pediatric patients with active Crohn's disease, with less clear guidelines on use in patients with ulcerative colitis. The field of immune modulating nutrition is an evolving science that takes into consideration the specific mechanism of action of nutrients, nutrient-nutrient interaction, and preexisting nutritional status of the patients.

Randomized Controlled Trial on the Effect of Partially Hydrolyzed Guar Gum Supplementation on Diarrhea Frequency and Gut Microbiome Count Among Pelvic Radiation Patients

“…Patients with malnutrition are at greater risk of toxicity induced by chemotherapy, with lower response to treatment and shorter lifespans 32 . Besides that, continuous weight loss is an indicator of malnutrition for patients undergoing pelvic radiation 33 . In the current study, both patient groups experienced weight loss, with 4% total weight loss from baseline until the end of pelvic radiation treatment (6 weeks) (IG 3% and CG 6%).…”

Complementary Lipidomic, Proteomic, and Mass Spectrometry Imaging Approach to the Characterization of the Acute Effects of Radiation in the Non-human Primate Mesenteric Lymph Node after Partial-body Irradiation with Minimal Bone Marrow Sparing

“…The exact reason for this accumulation in the MLN is unknown; however, in our study, no protein changes were linked to those species, which would suggest that they originate from outside of the node. The most affected TG are longer chain triglycerides, and they are more difficult to digest for the intestine as they need bile and carnitine contrary to medium chains (DeWitt and Hegazi 2014). Therefore, this accumulation could originate from the intestinal alterations due to GI-ARS.…”

Inflammatory bowel disease-associated malignancies and considerations for radiation impacting bowel: a scoping review

“…Moreover, IBD patients with lower BMI may be more likely to suffer flares in the periradiation period (44). Nutritional therapy recommendations for both IBD and pelvic radiation disease (PRD) share common management goals, including increased caloric intake, limiting dairy products, lowering fat content, and increasing protein content (138). There is evidence that the introduction of an elemental/oligomeric enteral diet may improve both IBD and PRD (138)(139)(140).…”