Skip to main content
SpringerLink
Log in

Dietary Management

  • Chapter
  • First Online:
Inflammatory Bowel Disease Nursing Manual

  • 1482 Accesses

Abstract

All IBD patients should have access to dietitians for nutrition support and, where appropriate, for primary therapy of IBD (Donnellan et al., Ther Adv Gastroenterol 6:231–242, 2013; ibd standards: http://s3-eu-west-1.amazonaws.com/files.crohnsandcolitis.org.uk/Publications/PPR/ibd_standards_13.pdf). Dietary management of IBD remains poorly understood (Charlebois et al., Crit Rev Food Sci Nutr 56:1370–1378, 2016); most guidelines do not make recommendations for it (Halmos and Gibson, Nat Rev Gastroenterol Hepatol 12:133–146, 2015) or are insufficiently detailed (Lee et al., J Hum Nutr Diet 27:207–218, 2014).

However, there is much published about dietary management of IBD. Some dietary interventions are now well supported by the evidence, but others require more research and, as such, cannot yet be used as evidence-based practice. The individual with IBD may struggle with the array of information and, together with Internet contradictions and well-meaning help from suboptimally qualified advice givers, is at risk of employing dietary strategies which could be inappropriate to their clinical situation. The IBD MDT, therefore, must help by providing a clear consistent approach about dietary management of IBD.

Dietary management of IBD can be a confusing field due to how different clinical situations such as disease type, patient’s age or stage in the disease, for example, may change what advice is appropriate. This chapter will discuss dietary management strategies, when to apply them but also when not to. It aims to present the available dietary information alongside the current thinking to enable the reader to discern what may or may not be appropriate for their patients. The reader will:

  • Become familiar with dietary management strategies.

  • Become familiar with the current evidence base for different aspects of management.

  • Gain some practical tips and resources.

  • Understand the role and scope of dietetic services for IBD patients.

  • Appreciate that appropriate dietary management will differ from patient to patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Barbalhoa SM, de Alvares Goulartb R, Quesadac K, Becharad MD, de Carvalhoe A d CA (2016) Inflammatory bowel disease: can omega-3 fatty acids really help? Ann Gastroenterol 29:37–43

    Google Scholar 

  • Borrelli O, Cordischi L, Cirulli M, Paganelli M, Labalestra V, Uccini S, Russo PM, Cucchiara S (2006) Polymeric diet alone versus corticosteroids in the treatment of active pediatric Crohn’s disease: a randomized controlled open-label trial. Clin Gastroenterol Hepatol 4:744–753

    Article  PubMed  Google Scholar 

  • Burch J (2013) Care of patients with a stoma. Nurs Stand 27(32):49–56. Date of submission: November 5 2012; date of acceptance: February 1 2013

    Article  PubMed  Google Scholar 

  • Charlebois A, Rosenfeld G, Bressler B (2016) The impact of dietary interventions on the symptoms of inflammatory bowel disease: a systematic review. Crit Rev Food Sci Nutr 56(8):1370–1378. https://doi.org/10.1080/10408398.2012.760515

    Article  CAS  PubMed  Google Scholar 

  • Cronin E (2012) Dietary advice for patients with a stoma. Br J Nurs 21(16):S32–S34 (Stoma Care Supplement)

    Article  PubMed  Google Scholar 

  • Day AS, Lopez RN (2015) Exclusive enteral nutrition in children with Crohn’s disease. World J Gastroenterol 21(22):6809–6816

    Article  PubMed  PubMed Central  Google Scholar 

  • Dignass A, Lindsay JO, Sturm A, Windsor A, Colombel J-F, Allez M, D’Haens G, D’Hoore A, Mantzaris G, Novacek G et al (2012) Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis 6(10):991–1030. https://doi.org/10.1016/j.crohns.2012.09.002

    Article  PubMed  Google Scholar 

  • Donnellan CF, Yann LH, Lal S (2013) Nutritional management of Crohn’s disease. Ther Adv Gastroenterol 6(3):231–242. https://doi.org/10.1177/1756283X13477715

    Article  CAS  Google Scholar 

  • Durchschein F, Petritsch W, Hammer HF (2016) Diet therapy for inflammatory bowel diseases: the established and the new. World J Gastroenterol 22(7):2179–2194

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • El-Matary W, Otley A, Critch J, Abou-Setta AM (2017) Enteral feeding therapy for maintaining remission in Crohn’s disease a systematic review. JPEN J Parenter Enteral Nutr 41(4):550–561. https://doi.org/10.1177/0148607115621051. First Published July 11, 2016

    Article  PubMed  Google Scholar 

  • Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL, Navarro E, Martínez-Salmerón JF, García-Pugés A, González-Huix F, Riera J, González-Lara V, Domínguez-Abascal F, Giné JJ, Moles J, Gomollón F, Gassull MA (1999) Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU). Am J Gastroenterol 94:427–433

    Article  PubMed  Google Scholar 

  • Gibson PR (2017) Use of the low-FODMAP diet in inflammatory bowel disease. J Gastroenterol Hepatol 32(Suppl. 1):40–42

    Article  CAS  PubMed  Google Scholar 

  • Hallert C, Kaldma M, Petersson BG (1991) Ispaghula husk may relieve gastrointestinal symptoms in ulcerative colitis in remission. Scand J Gastroenterol 26:747–750

    Article  CAS  PubMed  Google Scholar 

  • Halmos EP, Gibson PR (2015).; published online 3 February 2015) Dietary management of IBD—insights and advice. Nat Rev Gastroenterol Hepatol 12:133–146. https://doi.org/10.1038/nrgastro.2015.11

    Article  CAS  PubMed  Google Scholar 

  • Kim S, Koh H (2015) Nutritional aspect of pediatric inflammatory bowel disease: its clinical importance. Korean J Pediatr 58(10):363–368

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kornbluth A, Sachar DB, The Practice Parameters Committee of the American College of Gastroenterology (2010) Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 105:501–523. https://doi.org/10.1038/ajg.2009.727; published online 12 January 2010

    Article  PubMed  Google Scholar 

  • Lee J, Allen R, Ashley S, Becker S, Cummins P, Gbadamosi A, Gooding O, Huston J, Le Couteur J, O’Sullivan D, Wilson S, Lomer MCE, on behalf of Gastroenterology Specialist Group of the British Dietetic Association (2014) British Dietetic Association evidence-based guidelines for the dietary management of Crohn’s disease in adults. J Hum Nutr Diet 27:207–218. https://doi.org/10.1111/jhn.12176

    Article  CAS  PubMed  Google Scholar 

  • Mowat C, Cole A, Windsor A et al (2011) Guidelines for the management of inflammatory bowel disease in adults. Gut 60(5):571–607. https://doi.org/10.1136/gut.2010.224154

    Article  PubMed  Google Scholar 

  • Nakahigashi M, Yamamoto T, Sacco R, Hanai H, Kobayashi F (2016) Enteral nutrition for maintaining remission in patients with quiescent Crohn’s disease: current status and future perspectives. Int J Color Dis 31:1–7. https://doi.org/10.1007/s00384-015-2348-x

    Article  Google Scholar 

  • Nguyen DL, Palmer LB, Nguyen ET, McClave SA, Martindale RG, Bechtold ML (2015) Specialized enteral nutrition therapy in Crohn’s disease patients on maintenance infliximab therapy: a meta-analysis. Ther Adv Gastroenterol 8(4):168–175. https://doi.org/10.1177/1756283X15578607

    Article  Google Scholar 

  • Owczarek D, Rodacki T, Domagała-Rodacka R, Cibor D, Mach T (2016) Diet and nutritional factors in inflammatory bowel diseases. World J Gastroenterol 22(3):895–905

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Penagini F, Dilillo D, Borsani B, Cococcioni L, Galli E, Bedogni G, Zuin G, Zuccotti GV (2016) Nutrition in pediatric inflammatory bowel disease: from etiology to treatment. A systematic review. Nutrients 8:334. https://doi.org/10.3390/nu8060334

    Article  CAS  PubMed Central  Google Scholar 

  • Pituch-Zdanowska A, Banaszkiewicz A, Albrecht P (2015) The role of dietary fibre in inflammatory bowel disease. Prz Gastroenterol 10(3):135–141

    CAS  PubMed  PubMed Central  Google Scholar 

  • Raghu Subramanian C, Triadafilopoulos G (2016) Care of inflammatory bowel disease patients in remission. Gastroenterol Rep 4(4):261–271

    Google Scholar 

  • Sadeghian M, Saneei P, Siassi F, Esmaillzadeh A (2016) Vitamin D status in relation to Crohn’s disease: Meta-analysis of observational studies. Nutrition 32(5):505–514. https://doi.org/10.1016/j.nut.2015.11.008. Epub 2015 Dec 22

    Article  CAS  PubMed  Google Scholar 

  • Schwartz E (2016) Perioperative parenteral nutrition in adults with inflammatory bowel disease: a review of the literature. Nutr Clin Pract 31(2):159–170

    Article  CAS  PubMed  Google Scholar 

  • Shah ND, Parian AM, Mullin GE, Limketkai BN (2015) Oral diets and nutrition support for inflammatory bowel disease: what is the evidence?. Nutr Clin Pract 30(4):462–473 © 2015 American Society for Parenteral and Enteral Nutrition. https://doi.org/10.1177/0884533615591059 ncp.sagepub.com hosted at online.sagepub.com

    Article  CAS  PubMed  Google Scholar 

  • Staudacher HM et al (2014).; published online 21 January 2014) Mechanisms and efficacy of dietary FODMAP restriction in IBS. Nat Rev Gastroenterol Hepatol 11:256–266. https://doi.org/10.1038/nrgastro.2013.259

    Article  CAS  PubMed  Google Scholar 

  • Tsertsvadze A, Gurung T, Court R, Clarke A, Sutcliffe P (2015) Clinical effectiveness and cost-effectiveness of elemental nutrition for the maintenance of remission in Crohn’s disease: a systematic review and meta-analysis. Health Technol Assess 19(26):1–138

    Article  PubMed  PubMed Central  Google Scholar 

  • Verma S, Holdsworth C, Giaffer M (2001) Does adjuvant nutritional support diminish steroid dependency in Crohn disease? Scand J Gastroenterol 36:383–388

    Article  CAS  PubMed  Google Scholar 

  • Wedlake L, Slack N, Andreyev HJ, Whelan K (2014) Fiber in the treatment and maintenance of inflammatory bowel disease: a systematic review of randomized controlled trials. Inflamm Bowel Dis 20:576–586

    Article  PubMed  Google Scholar 

  • Wędrychowicz A, Zając A, Tomasik P (2016) Advances in nutritional therapy in inflammatory bowel diseases: review 2016 inflammatory bowel disease: global view. World J Gastroenterol 22(3):1045–1066

    Article  PubMed  PubMed Central  Google Scholar 

  • Weisshof R, Chermesh I (2015) Micronutrient deficiencies in IBD. Curr Opin Clin Nutr Metab Care 18:576–581

    Article  CAS  PubMed  Google Scholar 

  • Wong C, Harris PJ, Ferguson LR (2016) Potential benefits of dietary fibre intervention in inflammatory bowel disease. Int J Mol Sci 17:919. https://doi.org/10.3390/ijms17060919

    Article  PubMed Central  Google Scholar 

  • Yamamoto T et al (2017) Dietary and enteral interventions for Crohn’s disease. Curr Opin Biotechnol 44:69–73

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oxford University Hospitals NHS Trust, Oxford, UK

    Lisa Vokes

Authors
  1. Lisa Vokes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa Vokes .

Editor information

Editors and Affiliations

  1. DRK Kliniken Berlin Westend, Department of Gastroenterology, Berlin, Germany

    Andreas Sturm

  2. Gastroenterology Level 5, John Radcliffe Hospital, Oxford, UK

    Lydia White

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Vokes, L. (2019). Dietary Management. In: Sturm, A., White, L. (eds) Inflammatory Bowel Disease Nursing Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-75022-4_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-75022-4_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75021-7

  • Online ISBN: 978-3-319-75022-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation