Advances in nutritional therapy in inflammatory bowel diseases: Review

World J Gastroenterol. 2016 Jan 21;22(3):1045-66. doi: 10.3748/wjg.v22.i3.1045.

Abstract

Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are suspected as triggering factors in the etiopathogenesis of IBD. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility in different populations and in different countries is not clearly established, and there are sometimes conflicting theories concerning the role of nutrition in IBD. This review presents the actual data from research studies on the influence of nutrition on the etiopathogenesis of IBD and the latest findings regarding its mechanisms of action. The use of both parenteral and enteral nutrition as therapeutic methods in induction and maintenance therapy in IBD treatment is also extensively discussed. Comparison of the latest research data, scientific theories concerning the role of nutrition in IBD, and different opinions about them are also presented and discussed. Additionally, some potential future perspectives for nutritional therapy are highlighted.

Keywords: Dietary factors; Etiology; Exclusive enteral nutrition; Induction therapy; Inflammatory bowel disease; Maintenance therapy; Nutritional therapy; Parenteral nutrition.

Publication types

  • Review

MeSH terms

  • Body Composition
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / etiology
  • Colitis, Ulcerative / physiopathology
  • Colitis, Ulcerative / therapy*
  • Crohn Disease / diagnosis
  • Crohn Disease / etiology
  • Crohn Disease / physiopathology
  • Crohn Disease / therapy*
  • Diet / adverse effects
  • Diffusion of Innovation
  • Enteral Nutrition* / adverse effects
  • Enteral Nutrition* / trends
  • Humans
  • Nutritional Status
  • Parenteral Nutrition* / adverse effects
  • Parenteral Nutrition* / trends
  • Risk Factors
  • Treatment Outcome