The Modification of the Gut Microbiota via Selected Specific Diets in Patients with Crohn’s Disease

Abstract

Gastrointestinal symptoms in Crohn’s disease (CD) are common and affect the quality of life of patients; consequently, a growing number of studies have been published on diet interventions in this group. The role of the gut microbiota in the pathogenesis and the progression of inflammatory bowel diseases (IBD), including CD, has been widely discussed. Mainly, a decreased abundance of Firmicutes, species of the Bifidobacterium genus, and the Faecalibacterium prausnitzii species as well as a reduced general diversity have been described. In this review article, we summarize available data on the influence of reduction diets on the microbiome of patients with CD. One of the most frequently used elimination diets in CD patients is the low-FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet. Although many papers show it may reduce abdominal pain, diarrhea, or bloating, it also reduces the intake of prebiotic substances, which can negatively affect the gut microbiota composition, decreasing the abundance of Bifidobacterium species and Faecalibacterium prausnitzii. Other elimination diets used by IBD patients, such as lactose-free or gluten-free diets, have also been shown to disturb the microbial diversity. On the other hand, CDED (Crohn’s disease exclusion diet) with partial enteral nutrition not only induces the remission of CD but also has a positive influence on the microbiota. The impact of diet interventions on the microbiota and, potentially, on the future course of the disease should be considered when nutritional guidelines for IBD patients are designed. Dietetic recommendations should be based not only on the regulation of the symptoms but also on the long-term development of the disease.

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Food Additives, a Key Environmental Factor in the Development of IBD through Gut Dysbiosis

“…This alternative diet has gained popularity among physicians, especially for its use as a treatment option in IBD [5]. However, its long-term impact on the microbiota appeared disadvantageous with a general decrease in butyrate-producing bacteria [49]. Moreover, a low-FODMAP diet can lead to a reduction in potential prebiotics (fructo-oligosaccharides and galacto-oligosaccharides), thus leading to a reduction in beneficial bacteria and fermentative effects [50].…”

FODMAPs, inflammatory bowel disease and gut microbiota: updated overview on the current evidence

“…Therefore, nutrition interventions may play an important role in the improvement of IBD symptoms and in disease remission [42]. In the past few years, several dietary interventions have been studied for potential therapeutic effects on IBD [43]. Among those interventions are the specific carbohydrate diet [44], exclusive enteral nutrition [45], gluten-free diet [46], and the anti-inflammatory diet [47].…”