Nutrition and dietary interventions in adults with inflammatory bowel disease
- Mark H DeLegge, MD, FACG, AGAF
Mark H DeLegge, MD, FACG, AGAF
- Professor of Medicine
- Medical University of South Carolina
- Section Editors
- Paul Rutgeerts, MD, PhD, FRCP
Paul Rutgeerts, MD, PhD, FRCP
- Section Editor — Inflammatory Bowel Disease
- Emeritus Professor of Medicine
- University Hospital, Leuven, Belgium
- Timothy O Lipman, MD
Timothy O Lipman, MD
- Section Editor — Nutrition
- GI-Hepatology-Nutrition Section
- Washington DC Veterans Affairs Medical Center
Inflammatory bowel disease (IBD) is an inflammatory disorder of the gastrointestinal tract leading to symptoms of pain, nausea, fever, and diarrhea . These symptoms can result in loss of appetite, reduced nutrient intake, altered nutrient metabolism, and ultimately impaired nutritional status. Loss of appetite is most likely the result of inflammation and the release of cytokines such as IL-1, IL-6, and tumor necrosis factor.
Dietary interventions in IBD focus on maximizing nutritional status, maintaining adequate intake, and avoiding foods that can exacerbate symptoms.
The prevalence of nutritional deficiencies and malnutrition has been well documented in IBD, especially in Crohn disease . It is important to identify patients who are malnourished in order to identify those patients who may require nutritional intervention. Optimizing nutritional status is important both to prevent long-term health consequences of malnutrition as well as to prevent relapses in patients with IBD.
This topic review will discuss nutrition and dietary interventions in adults with inflammatory bowel disease. Specific nutrient deficiencies in IBD, as well as growth failure and poor weight gain in children with IBD, are discussed separately. Dietary risk factors for IBD are also discussed separately. (See "Nutrient deficiencies in inflammatory bowel disease" and "Growth failure and poor weight gain in children with inflammatory bowel disease" and "Definition, epidemiology, and risk factors in inflammatory bowel disease", section on 'Diet'.)
The nutritional status of patients with inflammatory bowel disease (IBD) should be assessed to determine if dietary intervention is necessary. Measuring a patient's nutritional status involves a comprehensive assessment. This may include measuring body composition, dietary intake, energy expenditure, body function, and serum protein markers. (See "Dietary assessment in adults".)
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- NUTRITIONAL ASSESSMENT
- CAUSES OF MALNUTRITION
- CONSEQUENCES OF MALNUTRITION
- Growth failure
- Weight loss and reduced muscle mass
- Bone disease
- Micronutrient deficiencies
- DIETARY INTERVENTIONS
- Nutrition supplementation
- Total parenteral nutrition
- Elimination diet
- Low-carbohydrate diet
- Other dietary interventions
- - Fiber
- - Prebiotics
- - Omega-3 polyunsaturated fatty acids
- - Antioxidants
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS