Potential Benefits of Dietary Fibre Intervention in Inflammatory Bowel Disease

Abstract

Intestinal dysbiosis is thought to be an important cause of disease progression and the gastrointestinal symptoms experienced in patients with inflammatory bowel disease (IBD). Inflammation appears to be a major contributor in perpetuating a dysregulated gut microbiota. Although current drug therapies can significantly induce and maintain disease remission, there is no cure for these diseases. Nevertheless, ongoing human studies investigating dietary fibre interventions may potentially prove to exert beneficial outcomes for IBD. Postulated mechanisms include direct interactions with the gut mucosa through immunomodulation, or indirectly through the microbiome. Component species of the microbiome may degrade dietary-fibre polysaccharides and ferment the products to form short-chain fatty acids such as butyrate. Prebiotic dietary fibres may also act more directly by altering the composition of the microbiome. Longer term benefits in reducing the risk of more aggressive disease or colorectal cancer may require other dietary fibre sources such as wheat bran or psyllium. By critically examining clinical trials that have used dietary fibre supplements or dietary patterns containing specific types or amounts of dietary fibres, it may be possible to assess whether varying the intake of specific dietary fibres may offer an efficient treatment for IBD patients.

Therapeutic effects of lentinan on inflammatory bowel disease and colitis‐associated cancer

“…IBD is facilitated by immune hyper‐responsiveness towards certain intestinal microbiota, which is critical in stimulating mucosal immune disorders . Studies have shown that polysaccharides are capable of balancing the intestinal microbiota . We performed 16S rRNA gene sequencing on faecal samples from normal or acute colitis model mice treated with or without lentinan to investigate changes in intestinal microbiota because of lentinan treatment.…”

“…34 Studies have shown that polysaccharides are capable of balancing the intestinal microbiota. 35,36 We performed Figure 7B). This finding is consistent with a previous study that reported a decrease of Firmicutes and an increase of Proteobacteria in IBD patients.…”

The Relevance of Vitamin and Iron Deficiency in Patients with Inflammatory Bowel Diseases in Patients of the Swiss IBD Cohort

“…49 As possible mode of actions, it is hypothesized that dietary fibers directly interact with the intestinal microbiome, eg, by modulating intestinal immune responses or by directly affecting intestinal microbiota composition. 20 Therefore, based on the literature, a fiber-rich diet seems to have beneficial effects for IBD patients and should be promoted by the treating physicians.…”

“…19 An important preventive measure in the management of IBD patients is to provide proper nutrition (especially a fiber-rich diet), that may play a role in maintaining remission in those patients. 20 The selection of a proper therapy, such as biological therapy, which is used with increasing frequency, seems not only to mitigate the inflammatory process in the gastrointestinal (GI) tract, but also to provide beneficial effects on the nutritional status of patients with CD, thus denoting the increasing importance of medications in vitamins and micronutrient levels. 21 Taken together current evidence suggests that vitamins might play an important role for the disease course and outcome of IBD patients.…”

The role of dietary factors in inflammatory bowel diseases: New perspectives

“…Remarkably, fibers of different sources have varied effects on colitis, among which psyllium, pectin and cellulose fibers had protective effects contrary to methylcellulose . Additionally, the effect of dietary fiber varies between CD and UC …”