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Diet therapy for inflammatory bowel diseases: The established and the new.
World J Gastroenterol 2016; 22(7):2179-94WJ

Abstract

Although patients with inflammatory bowel diseases (IBD) have a strong interest in dietary modifications as part of their therapeutic management, dietary advice plays only a minor part in published guidelines. The scientific literature shows that dietary factors might influence the risk of developing IBD, that dysbiosis induced by nutrition contributes to the pathogenesis of IBD, and that diet may serve as a symptomatic treatment for irritable bowel syndrome-like symptoms in IBD. The role of nutrition in IBD is underscored by the effect of various dietary therapies. In paediatric patients with Crohn's disease (CD) enteral nutrition (EN) reaches remission rates similar to steroids. In adult patients, however, EN is inferior to corticosteroids. EN is not effective in ulcerative colitis (UC). Total parenteral nutrition in IBD is not superior to steroids or EN. The use of specific probiotics in patients with IBD can be recommended only in special clinical situations. There is no evidence for efficacy of probiotics in CD. By contrast, studies in UC have shown a beneficial effect in selected patients. For patients with pouchitis, antibiotic treatment followed by probiotics, like VSL#3 or Lactobacillus GG, is effective. When probiotics are used, the risk of bacterial translocation and subsequent bacteremia has to be considered. More understanding of the normal intestinal microflora, and better characterization of probiotic strains at the phenotypic and genomic levels is needed as well as clarification of the mechanisms of action in different clinical settings. A FODMAP reduced diet may improve symptoms in IBD.

Authors+Show Affiliations

Franziska Durchschein, Wolfgang Petritsch, Heinz F Hammer, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, 8036 Graz, Austria.Franziska Durchschein, Wolfgang Petritsch, Heinz F Hammer, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, 8036 Graz, Austria.Franziska Durchschein, Wolfgang Petritsch, Heinz F Hammer, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, 8036 Graz, Austria.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26900283

Citation

Durchschein, Franziska, et al. "Diet Therapy for Inflammatory Bowel Diseases: the Established and the New." World Journal of Gastroenterology, vol. 22, no. 7, 2016, pp. 2179-94.
Durchschein F, Petritsch W, Hammer HF. Diet therapy for inflammatory bowel diseases: The established and the new. World J Gastroenterol. 2016;22(7):2179-94.
Durchschein, F., Petritsch, W., & Hammer, H. F. (2016). Diet therapy for inflammatory bowel diseases: The established and the new. World Journal of Gastroenterology, 22(7), pp. 2179-94. doi:10.3748/wjg.v22.i7.2179.
Durchschein F, Petritsch W, Hammer HF. Diet Therapy for Inflammatory Bowel Diseases: the Established and the New. World J Gastroenterol. 2016 Feb 21;22(7):2179-94. PubMed PMID: 26900283.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diet therapy for inflammatory bowel diseases: The established and the new. AU - Durchschein,Franziska, AU - Petritsch,Wolfgang, AU - Hammer,Heinz F, PY - 2015/06/25/received PY - 2015/11/10/revised PY - 2015/12/30/accepted PY - 2016/2/23/entrez PY - 2016/2/24/pubmed PY - 2017/1/18/medline KW - Crohn’s disease KW - Enteral nutrition KW - Fermentable oligo-, di-, and monosaccharides and polyols KW - Parenteral nutrition KW - Probiotics KW - Ulcerative colitis SP - 2179 EP - 94 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 22 IS - 7 N2 - Although patients with inflammatory bowel diseases (IBD) have a strong interest in dietary modifications as part of their therapeutic management, dietary advice plays only a minor part in published guidelines. The scientific literature shows that dietary factors might influence the risk of developing IBD, that dysbiosis induced by nutrition contributes to the pathogenesis of IBD, and that diet may serve as a symptomatic treatment for irritable bowel syndrome-like symptoms in IBD. The role of nutrition in IBD is underscored by the effect of various dietary therapies. In paediatric patients with Crohn's disease (CD) enteral nutrition (EN) reaches remission rates similar to steroids. In adult patients, however, EN is inferior to corticosteroids. EN is not effective in ulcerative colitis (UC). Total parenteral nutrition in IBD is not superior to steroids or EN. The use of specific probiotics in patients with IBD can be recommended only in special clinical situations. There is no evidence for efficacy of probiotics in CD. By contrast, studies in UC have shown a beneficial effect in selected patients. For patients with pouchitis, antibiotic treatment followed by probiotics, like VSL#3 or Lactobacillus GG, is effective. When probiotics are used, the risk of bacterial translocation and subsequent bacteremia has to be considered. More understanding of the normal intestinal microflora, and better characterization of probiotic strains at the phenotypic and genomic levels is needed as well as clarification of the mechanisms of action in different clinical settings. A FODMAP reduced diet may improve symptoms in IBD. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/26900283/Diet_therapy_for_inflammatory_bowel_diseases:_The_established_and_the_new_ L2 - http://www.wjgnet.com/1007-9327/full/v22/i7/2179.htm DB - PRIME DP - Unbound Medicine ER -