Existing Dietary Guidelines for Crohn's Disease and Ulcerative Colitis

Amy C Brown; S Devi Rampertab; Gerard E Mullin

Disclosures

Expert Rev Gastroenterol Hepatol. 2011;5(3):411-425. 

In This Article

Abstract and Introduction

Abstract

Patients with inflammatory bowel disease (IBD) often question their doctors about diet. The objectives of this article are to provide clinicians with existing dietary advice by presenting the dietary information proposed by medical societies in the form of clinical practice guidelines as it relates to IBD; listing dietary guidelines from patient-centered IBD-related organizations; and creating a new 'global practice guideline' that attempts to consolidate the existing information regarding diet and IBD. The dietary suggestions derived from sources found in this article include nutritional deficiency screening, avoiding foods that worsen symptoms, eating smaller meals at more frequent intervals, drinking adequate fluids, avoiding caffeine and alcohol, taking vitamin/mineral supplementation, eliminating dairy if lactose intolerant, limiting excess fat, reducing carbohydrates and reducing high-fiber foods during flares. Mixed advice exists regarding probiotics. Enteral nutrition is recommended for Crohn's disease patients in Japan, which differs from practices in the USA.

Introduction

Although physicians are not always taught information about diet and inflammatory bowel disease (IBD) in their training or through their professional associations, registered dietitians may also not be adequately prepared to present dietary information to patients with IBD. Based on our previous review of the literature on diet and Crohn's disease (CD), it appears that a large gap exists in translating research-based dietary knowledge to clinical practice for the IBD population.[1] Creating evidence-based dietary recommendations for people with IBD is an unaddressed need. These patients need up-to-date dietary clinical practice guidelines that will, if possible, best serve to reduce the risk of nutritional deficiency and possibly reduce their symptoms.

The current state of the art is that various clinical practice guidelines for IBD patients exist, but many are sparse on dietary recommendations, and vary by origin.

The objectives of this article are to:

  • Collectively present the dietary information relating to IBD in the form of clinical practice guidelines proposed by medical societies;

  • List the 'informal dietary guidelines' suggested by patient-centered IBD-related associations;

  • Create a new 'global practice guideline' that incorporates the current clinical practice guidelines and informal dietary recommendations into one consolidated set of guidelines;

  • Comment on existing nutrition guidelines for IBD and recommend future research.

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