Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity

Shinil Shah, DO, PGY-1

Disclosures

March 27, 2007

Introduction

Across every specialty, alternative approaches to conventional diseases are beginning to take hold. This is certainly no different for patients suffering from ulcerative colitis and Crohn's disease. These 2 conditions, collectively referred to as the inflammatory bowel diseases, have an estimated prevalence of 149 per 100,000 whites, with increasing, but similar rates in blacks, and lower rates in Hispanics and Asians.[1]

Despite much effort and research, the etiology of this disease process continues to remain elusive. Many suspect an immune-mediated process, and standard therapy includes 5-aminosalicylate derivatives, corticosteroids, and various immune-modulating drugs (eg, 6-mercaptopurine, azathioprine, etc). Newer, more selective biologic agents such as monoclonal antibodies are beginning to emerge as effective from successful clinical trials.

In spite of these therapies, many turn to alternative medicine to seek relief from their symptoms. This may be secondary to a variety of reasons, including undesirable/unwanted medication side effects or lack or efficacy. Surveys have shown that those with a poorer quality of life turn to alternative medicine in greater numbers.[2] However, a poorly regulated industry that profits from the shortcomings of modern medicine awaits those patients who seek alternative therapies. There are purported miracle cures for almost any disease, often without evidence to support their purported effectiveness. However, some forms of alternative therapies have shown efficacy in clinical studies.

Diet is an especially attractive forum to modulate the inflammatory process. Dietary factors have been shown to modulate the pathogenesis of a variety of conditions, including celiac disease, colon cancer, and diverticulosis, and some believe it may play a role in the pathogenesis of inflammatory bowel disease. The purpose of this article is to provide a review of some of what is known about proposed dietary and nutritional factors and the evidence supporting its effect on inflammatory bowel disease from various research studies.

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