Patient’s Dietary Beliefs and Behaviours in Inflammatory Bowel Disease

Abstract

Background: The inflammatory bowel disease (IBD) is a chronic lifelong inflammation that may affect the entire gastro-intestinal tract in Crohn’s disease and the colon in ulcerative colitis (UC). Diet plays an important role in IBD patients and many of them follow strict diet restriction in order to reduce complaints and prolong remission intervals. The aim of this study was to assess dietary beliefs, dietary behaviour and nutrition knowledge in Dutch adults with IBD to enable considering the patient’s perspective on dietary advice. Methods: A self-administered online questionnaire assessing general characteristics, dietary beliefs and behaviour, nutrition knowledge and sources and dietary advice was devised. The questionnaire was distributed to members of the Dutch Crohn and UC patient association of whom 294 participated in the study. Results: Fifty-nine per cent of the patients valued nutrition to be either more or equally important compared to medication for their treatment and 62% believed diet to be more important in influencing the disease course. Sixty-two per cent reported to be successful in controlling disease symptoms through dietary adaptations. Avoiding certain foods was preferred over eating more beneficial foods or following specific diets (77 vs. 57% and 48% respectively). Dietary supplements were used by 68% of the IBD patients. Although over 71% had received dietary advice mainly by dieticians, 81% stated that the main source of their nutritional knowledge related to IBD was their own experience. Conclusion: A subgroup of IBD patients considered diet to be a more important and successful managing tool than medication to relieve their disease symptoms.

Inflammatory Bowel Disease: Are Symptoms and Diet Linked?

“…In the present study, 55% of participants reported an association between dietary elements and the onset of their IBD symptoms, consistent with the range of 33–68% observed in other studies [ 15 , 17 , 32 , 33 , 34 ]. Moreover, within the range seen in other studies (44–76.5%) [ 32 , 34 , 35 , 36 , 37 , 38 ] a greater percentage of participants (70%) reported an association between diet and symptom exacerbation.…”

“…The diversity of fruit identified was also less than vegetables, making it difficult to identify a common factor. Citrus fruits have previously been singled out as being problematic [ 32 , 38 , 43 , 48 ], an observation not evident in this study with only one citrus fruit, orange, amongst the most frequently identified fruits. Considering each fruit individually, it is unclear how apple and orange could elicit GI irritation.…”

Nutrition, IBD and Gut Microbiota: A Review

“…Given this scenario, an increasing interest has been given to diet as an easily modifiable environmental factor and, therefore, as a possible preventive or treatment option for IBD [99]. Indeed, IBD patients themselves attribute more importance to diet in affecting their symptoms, than to pharmaceutical treatment [129].…”

Ernährung bei entzündlichen Darmerkrankungen

“…Auch wenn Patienten mit IBD großes Interesse an dem Thema Ernährung haben, sind lediglich 8–16% mit den Informationen, die sie von ihren Ärzten erhalten, zufrieden [18]. Interessanterweise konzentrieren sich Patienten in dem Versuch, ihre Ernährungsgewohnheiten zu verändern, eher darauf, bestimmte Nahrungsmittel zu meiden als darauf, ihre Aufnahme von Nahrungsbestandteilen mit wahrscheinlich günstigeren Eigenschaften zu erhöhen [20]. Diese Einstellung ist möglicherweise für Patienten mit IBD wenig hilfreich, sondern führt bei ihnen eher zur eingeschränkten Aufnahme bestimmter Nahrungsmittel mit erheblichen Auswirkungen auf das Sozialleben [17] und zum potenziellen Risiko von Nährstoffdefiziten, u.a.…”