Dietary management of IBD—insights and advice

Halmos, Emma P; Gibson, Peter R.

doi:10.1038/nrgastro.2015.11

Cited by 79 publications

(58 citation statements)

References 157 publications

(133 reference statements)

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“…A LFD may be difficult to follow without guidance from a dietician to help individualize and optimize the diet in order to obtain a greater symptom response[45]. In addition, guidance from a dietician ensures better nutritional adequacy during the use of the restrictive LFD.…”

Section: Discussionmentioning

confidence: 99%

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

Pedersen

Ankersen

Felding

et al. 2017

WJG

151

122

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AIMTo investigate the effect of a low-FODMAP diet on irritable bowel syndrome (IBS)-like symptoms in patients with inflammatory bowel disease (IBD).METHODSThis was a randomised controlled open-label trial of patients with IBD in remission or with mild-to-moderate disease and coexisting IBS-like symptoms (Rome III) randomly assigned to a Low-FODMAP diet (LFD) or a normal diet (ND) for 6 wk between June 2012 and December 2013. Patients completed the IBS symptom severity system (IBS-SSS) and short IBD quality of life questionnaire (SIBDQ) at weeks 0 and 6. The primary end-point was response rates (at least 50-point reduction) in IBS-SSS at week 6 between groups; secondary end-point was the impact on quality of life.RESULTSEighty-nine patients, 67 (75%) women, median age 40, range 20-70 years were randomised: 44 to LFD group and 45 to ND, from which 78 patients completed the study period and were included in the final analysis (37 LFD and 41 ND). There was a significantly larger proportion of responders in the LFD group (n = 30, 81%) than in the ND group (n = 19, 46%); (OR = 5.30; 95%CI: 1.81-15.55, P < 0.01). At week 6, the LFD group showed a significantly lower median IBS-SSS (median 115; inter-quartile range [IQR] 33-169) than ND group (median 170, IQR 91-288), P = 0.02. Furthermore, the LFD group had a significantly greater increase in SIBDQ (median 60, IQR 51-65) than the ND group (median 50, IQR 39-60), P < 0.01.CONCLUSIONIn a prospective study, a low-FODMAP diet reduced IBS-like symptoms and increased quality of life in patients with IBD in remission.

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Section: Discussionmentioning

confidence: 99%

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

Pedersen

Ankersen

Felding

et al. 2017

WJG

151

122

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“…Often simple changes in diet, taking natural supplements, and developing a program for stress relief can make a profound and lasting difference in IBD sufferer's life 29. If a patient is suffering from fatigue, anxiety, and depression, the first thing to be investigated is undernourishment and malnutrition of macro- and micronutrients in his or her diet 17,30. Through interventions to improve nutritional status, there are potentials for alleviating accompanying psychological states such as anxiety, depression, and fatigue through increased energy level and well-being.…”

Section: Discussionmentioning

confidence: 99%

Tolerance Limits, Self-understanding, and Stress Resilience in Integrative Recovery of Inflammatory Bowel Disease

Skrautvol

Nåden²

2017

Holistic Nursing Practice

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People living with chronic inflammatory bowel disease (IBD) experienced that knowledge about their embodied tolerance limits, diet, mental problem solving, and change in lifestyle together with integrative health care could promote recovery from their diagnosed disease in calmer periods of suffering. A hermeneutic approach was used to analyze interviews with patients living with IBD outside hospitals. Thirteen young adults between 18 and 45 years of age in calmer phases of IBD participated in the study. Three main themes emerged from the analysis of the interviews: (1) Understanding limits in embodied tolerance, (2) Restoring balance is creating a new equilibrium, and (3) Creating resilience through integrative care. Anxiety, depression, stress, insomnia, and fatigue are known consequences of IBD and create a lower degree of well-being for the patients. The digestive system is very important in establishing the interface between the body and the external world. Properly functioning digestion, psychosocial stress reduction, and sleep quality are important to rebuild a balanced immune system. Stress resilience during a patient's recovery from IBD requires self-understanding, self-recognition, and psychosocial support from health care professionals at hospital outpatient clinics.

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“…IBD can ultimately lead to malnutrition, which, unaddressed, might lead to unfavorable outcomes[27,28]. In the face of the overweight/obesity epidemic, BMI has lost some of its credibility as a marker of malnutrition[29].…”

Section: Discussionmentioning

confidence: 99%

Systemic interleukin-9 in inflammatory bowel disease: Association with mucosal healing in ulcerative colitis

Matusiewicz

Neubauer

Bednarz−Misa

et al. 2017

WJG

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AIMTo evaluate circulating IL9 in inflammatory bowel disease and disease-associated anemia/cachexia and assess its potential as a mucosal healing marker.METHODSSerum IL9 as well as other cytokines (IL1β, IL6, IL13, IFNγ, TNFα, and VEGF-A) were determined in 293 individuals: 97 patients with Crohn’s disease (CD) and 74 with ulcerative colitis (UC) and in 122 apparently healthy controls. The clinical activity of CD and UC was expressed in terms of the Crohn’s Disease Activity Index (CDAI) and the Mayo Scoring System (MDAI), respectively, and the severity of bowel inflammation in UC patients was assessed using Mayo endoscopic score. Cytokine concentrations were measured by a flow cytometry-based method using Luminex xMAP® technology. High-sensitive C-reactive protein concentrations (hsCRP) were determined in CD and UC patients using the enhanced immunoturbidimetric method.RESULTSSystemic IL9 was significantly lower in healthy individuals [9 pg/mL (95%CI: 8.2-10)] than in patients with inflammatory bowel disease (IBD): both inactive [14.3 pg/mL (11.9-19.9)] and active [27.6 pg/mL (24.5-32), P < 0.0001]. Cytokine concentrations were significantly higher in active CD [27.4 pg/mL (23.4-32.2)] and in active UC [32.7 pg/mL (27-38.9)] compared to inactive diseases [15.9 pg/mL (10.8-23.4) in CD and 19.4 pg/mL (13.9-27.1) in UC, P = 0.001]. IL9 correlated weakly with CDAI (ρ = 0.32, P = 0.003) and MDAI (ρ = 0.35, P = 0.002) and strongly with endoscopic inflammation in UC (ρ = 0.74, P < 0.0001). As a negative marker of mucosal healing (MH), IL9 had an accuracy superior to hsCRP and IL6 [97% (P < 0.0001), 67% (P = 0.071), and 55% (P = 0.525), respectively]. IL9 was significantly higher in cachectic IBD patients [30.25 pg/mL (24.4-37.5) vs 21.88 pg/mL (18-26.5), P = 0.026] and negatively correlated with hemoglobin concentrations (ρ = -0.27, P < 0.001). Multiple regression showed IL1β and IL13 to be the independent predictors of circulating IL9 in healthy individuals, IFNγ or IL6 in active and inactive UC, respectively, and IL13 and VEGF-A in both active and inactive CD.CONCLUSIONThe systemic IL9 level is higher in IBD and corresponds with endoscopic inflammation, suggesting its possible application as a negative marker of mucosal healing in UC.

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Dietary management of IBD—insights and advice

Cited by 79 publications

References 157 publications

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

Tolerance Limits, Self-understanding, and Stress Resilience in Integrative Recovery of Inflammatory Bowel Disease

Systemic interleukin-9 in inflammatory bowel disease: Association with mucosal healing in ulcerative colitis

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