Nutritional Implications of Dietary Interventions for Managing Gastrointestinal Disorders

Heidi M. Staudacher; Matthew Kurien; Kevin Whelan

Disclosures

Curr Opin Gastroenterol. 2018;34(2):105-111. 

In This Article

Abstract and Introduction

Abstract

Purpose of review: The aim of this review is to summarize some of the key dietary interventions recommended for common gastrointestinal disorders and to discuss recent evidence regarding their nutritional implications.

Recent findings: The gluten-free diet has been shown to negatively influence overall diet quality. The gluten-free diet is essential in celiac disease, although it is increasingly used for other perceived health benefits for which an analysis of perceived benefit should be weighed against any nutritional risks. Evidence from short-term controlled trials of a diet low in fermentable oligosaccharides, disaccharides, monosaccharide and polyols in irritable bowel syndrome suggests compromised intake of nutrients such as fiber, iron, and calcium, although findings vary across studies. Meanwhile long-term uncontrolled trials suggest dietary adequacy improves with reintroduction and personalization. Although high-fiber diets may be beneficial in diverticular disease and constipation, it may lead to reductions in energy intake and nutrient absorption in at-risk populations.

Summary: The role of therapeutic diets in the management of gastrointestinal disorders is increasingly recognized, but there are limited studies investigating their nutritional implications. The judicious use of dietetic expertise should minimize potential nutritional deficits, however further prospective trials are needed to identify the individuals and nutrients most at risk.

Introduction

Dietary interventions play an integral role in the management of some gastrointestinal disorders. Although diet remains the mainstay of treatment for celiac disease, there has been intensifying interest in the use of diet to manage irritable bowel syndrome (IBS), constipation, diverticular disease, and inflammatory bowel disease (IBD). There has been progressing momentum in the identification and/or evaluation of new dietary interventions for these disorders, but also much needed synthesis of findings in the form of systematic reviews and meta-analyses. Exclusion of one or more foods or dietary constituents for the purposes of managing gastrointestinal disorders may increase the risk of inadequate nutrient intake and may have other nutritional implications. This review will summarize some of the key dietary interventions recommended for common gastrointestinal disorders and discuss recent evidence regarding their nutritional implications.

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