Diet and nutritional factors in inflammatory bowel diseases

Abstract

Inflammatory bowel disease (IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy.

Dietary Approach to Ulcerative Colitis Disease: Up to Date: Review

“…15 Basit şekerin yüksek miktarlarda alımının hastalığın gelişimini artırdığı bildirilmektedir. 16 Özellikle basit karbonhidratlardan zengin kolalı içeceklerin ve çikolata tüketiminin hastalık riskini artırdığı bildirilmektedir. 17 Diğer taraftan laktoz tü-ketimiyle hastalığın gelişimi arasında ilişki olmadığı belirtilmektedir.…”

“…Bunun yanı sıra, hastanın biyokimyasal bulgularına göre suplementasyon uygulaması yapılabilmektedir. 16 İzzet ÜLKER ve ark.…”

“…30 İBH hastalarının remisyon dönemine girmesini sağla-mada ve remisyon döneminde kalmasında probiyotikler önemli rol oynayabilmektedir. 16 Bir meta-analiz sonucuna göre, Bifidobacterium longum, Bifidobacterium infantis ve Streptococcus thermophilus bakterilerinden oluşan probiyotik suplementasyonunun ülseratif kolit hastalarında olumlu etkisinin olduğu gösterilmiştir. 31 Yapılan başka bir çalışmada ise Lactobacillus ve Saccharomyces boulardii bakterilerinden oluşan suplementasyonunun olumlu sonuçları bildirilmiştir.…”

Nutritional Therapy for Inflammatory Bowel Disease

“…Low-fiber or even so-called low-residue diets are frequently recommended during acute exacerbations of IBD [78]. While a low-fiber diet excludes only insoluble fiber, a low-residue diet requires exclusion of not only all vegetables, fruits, whole grains, legumes, but also dairy products and fibrous meat [79].…”

Effects of a low FODMAP diet and specific carbohydrate diet on symptoms and nutritional adequacy of patients with irritable bowel syndrome: Preliminary results of a single-blinded randomized trial

“…[13][14][15] FODMAPs can pass unabsorbed to the colon, where they increase the luminal water through osmotic activity and induce gas production (H2, CH4) due to fermentation by colonic bacteria, and lead to luminal distension and GI symptoms in susceptible individuals. [16][17][18][19] Another approach is the Specific Carbohydrate Diet (SCD) proposed by the Gastroenterologist Sidney Hass in 1951. The diet allows carbohydrate foods consisting of monosaccharides only, and excludes disaccharides and most polysaccharides (such as linear or branch-chained multiple sugars or starches).…”