Abstract
Diet and nutrition both play a role in the treatment of Crohn’s disease (CD). Diet is defined as the food a person eats whereas nutrition is the process by which the body uses nutrients from the diet. Research suggests that there is an epidemiologic association between diet and CD, yet to date there is no consistent evidence that any specific food or diet causes the development of or induces a flare of CD. Nor is there evidence that diet can cure CD (Diet, nutrition, and inflammatory bowel disease. Crohn’s and Colitis Foundation of America). However, diet can have a significant impact on patient symptoms. In addition, CD is associated with protein calorie malnutrition and vitamin and mineral deficiencies. Therefore, adequate diet and nutrition are essential to the management of CD and should be used in conjunction with medical and surgical treatments for the most effective outcome. In this chapter we will explore diet recommendations, common nutritional complications, how to identify and treat nutrient deficiencies, and explore some of the growing evidence for a connection between diet and development of CD.
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Abbreviations
- CD:
-
Crohn’s disease
- EN:
-
Enteral nutrition
- FODMAPS:
-
Fermentable oligo- di-mono saccharides and polyols
- IBD:
-
Inflammatory bowel disease
- MSVS:
-
Multivitamin mineral supplement
- SCFA:
-
Short chain fatty acids
- TPN:
-
Total parenteral nutrition
- UC:
-
Ulcerative colitis
References
Diet, nutrition, and inflammatory bowel disease. Crohn’s and Colitis Foundation of America. Available at http://www.ccfa.org/assets/pdfs/diet-nutrition-2013.pdf.
Lomer M. Symposium 7: nutrition in inflammatory bowel disease dietary and nutritional considerations for inflammatory bowel disease. Proc Nutr Soc. 2011;70:329–35.
Lichtenstein G, et al. Management of Crohn’s disease in adults. American College of Gastroenterology. Available at: www.gicare.org/guidelines/management-of-crohn’s-disease-in-adults/. 2009.
Long M, Cimperman L. Food for thought: nutrition & IBD. Crohn’s and Colitis Foundation of America; 2013 Sept 4. www.ccfa.org. Available at www.ccfa.org/resources/food-for-thought.html.
Hou JK. Am J Gastroenterol. 2011;106(4):563–73.
Triggs C. Dietary factors in chronic inflammation: food tolerances and intolerances of a New Zealand Caucasian Crohn’s disease population. Mutat Res. 2010;690:123–38.
Dalessandro T. What to eat with IBD a comprehensive nutrition and recipe guide for Crohn’s disease and ulcerative colitis. Briarcliff Manor, New York. CMG Publishing 2006.
Eiden KA. Nutritional considerations in inflammatory bowel disease. Nutrition Issues in Pract Gastroenterol. Series 5 2003:34–54.
Cohen AB, et al. Dietary patterns and self reported associations of diet with symptoms of IBD. Dig Dis Sci May, 58(5):1322–1328.
Gentschew L, et al. Role of nutrition and microbiota insusceptibility to inflammatory bowel diseases. Mol Nutr Food Res. 2012;56:524–35.
Richman E. Review article: evidence-based dietary advice for patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38:1156–71.
Barrett JS, Gibson PR. Clinical ramifications of malabsorption of fructose and other short-chain carbohydrates. Nutrition Issues in Pract Gastroenterol. Series 53 2007;51–65.
Albenberg LG, et al. Food and the gut microbiota in IBD: a critical connection. Curr Opin Gastroenterol. 2012;28(4):314–20.
Barrett JS, Gibson PR. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and non-allergic food intolerance. FODMAPs or food chemicals? Ther Adv Gastroenterol. 2012;5(4):261–8.
Almeida AI, Correia M, et al. Nutritional risk screening in surgery: valid, feasible, easy! Clin Nutr. 2012;31:206–11.
Banh L. Serum proteins as markers of nutrition: what are we treating? Nutrition Issues in Pract Gastroenterol. 2006:46–64.
Guagnozzi D, et al. Anemia in inflammatory bowel disease: a neglected issue with relevant effects. World J Gastroenterol. 2014;20(13):3542–51.
Gomollon F, et al. Current management of iron deficiency anemia in inflammatory bowel disease: a practical guide. Drugs. doi:10.1007/s40265-013-013102.
Gasche C, et al. Iron, anemia, and inflammatory bowel diseases. Gut. 2004;53(8):1190–7.
Battat R, et al. Vitamin B12 deficiency in inflammatory bowel disease: prevalence, risk factors, evaluation, and management. Inflamm Bowel Dis. 2014;20(6):1120–8.
Pappa H. Vitamin D deficiency and supplementation in patients with IBD. Gastroenterol Hepatol (N Y). 2014;10(2):127–9.
Naik AS, et al. Nutritional care in adult inflammatory bowel disease. Pract Gastroenterol. 2012;36(6):18–27.
Lee HH, et al. Zinc absorption in human small intestine. Am J Physiol. 1989;256:G87–91.
Zinc, serum, random urine. Test catalog, Test ID: ZNS, ZNSU. Rochester, MN: Mayo Medical Laboratories. Available at: http://www.mayomedicallaboritories.com/test-catalog/Overview/8620. 2014.
Wapnir RA. Copper absorption and bioavailability. Am J Clin Nutr. 1998;67:1054S–60.
O’Donnell K. Severe micronutrient deficiencies in RYGB patients: rare but potentially devastating. Pract Gastroenterol. 2011;35(11):13–27.
Treatment of magnesium deficiency. Available at: www.nih.gov. 2014.
Treatment of magnesium deficiency. Available at: www.Mayoclinic.com. 2014.
Buchman AL. Nutritional therapy for Crohn’s disease. Nutrition Issues in Pract Gastroenterol. 2005:17–28.
Food allergy research and education. Available at: www.foodallergy.org. 2014.
Herfarth H. Prevalence of a gluten–free diet and improvement of clinical symptoms in patients with inflammatory bowel diseases. Inflamm Bowel Dis. 2014;20(7):1194–7.
Eswaran S, et al. Food: the forgotten factor in the irritable bowel syndrome. Gastrolenterol Clin North Am 2011 Mar:40(1):141–62.
Torio M. Nephrolithiasis as an extra-intestinal presentation of pediatric inflammatory bowel disease unclassified. J Crohns Colitis 2010 Dec; 4(6):674–8.
Crohn’s and Colitis Foundation. Extra intestinal complications: kidney disorders; Available at http://www.ccfa.org/resources/kidney-disorders.html. 2009.
McConell N. Risk factors for developing renal stones in inflammatory bowel disease. BJU Int. 2002;89(9):835–41.
Nutrition for people with stomas 2: an overview of dietary advice. Nursing Times. 2008 Dec 104:49, 26–27.
Fulham J. Providing dietary advice for the individual with a stoma. Br J Nurs. 2008;17(2):S22–7.
Ostomy nutrition guide. University of Pittsburgh Medical Center; Available at http://www.upmc.com/patients-visitors/education/nutrition/pages/ostomy-nutrition-guide.aspx. 2014.
Burch J. Nutrition and the ostomate: input, output and absorption. Br J Community Nurs. 2006;11(8):349–51.
Parrish C. The clinicians guide to short bowel syndrome. Nutrition issues in gastroenterology series. Pract Gastroenterol. 2005:67–106.
Matarese L. Nutrition and fluid optimization for patients with short bowel syndrome. JPEN J Parenter Enteral Nutr. 2013;37(2):161–70.
DiBaise JK, Young RJ, Vanderhoof JA. Intestinal Rehab & the Short Bowel Syndrome: Part 1. Am J Gastro 2004;99:1386.
Day AS, et al. Exclusive enteral feeding as primary therapy for Crohn’s disease in Australian children and adolescents: a feasible and effective approach. J Gastroenterol Hepatol. 2006;21:1609–14.
Wild G, et al. World J Gastroenterol. 2007;13(1):1–7.
Bayless T, Hanauer S. Advanced therapy in inflammatory bowel disease. Volume II: IBD and Crohn’s disease. Perioperative Nutrition Supoort 2011;131:815–18.
Guagnozzi D, Gonzalez-Castillo S, et al. Nutritional treatment in inflammatory bowel disease, an update. Rev Esp Enferm Dig. 2012;104(9):479–88.
Engstrom P, Goosenberg E. Diagnosis and management of bowel diseases. 3rd ed. United Kingdom. Professional Communications. 2007.
Braga M, et al. Surgery. 2002;132:805–14.
Waitzberg DL, et al. World J Surg. 2006;30:1592–604.
McClave, Stephen A, Martindale, Robert G, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of critical care medicine (SCCM) and American society of parenteral and enteral nutrition A.S.P.E.N. JPEN J Parenter Enter Nutr 2009. May-Jun;33(3): 277–316.
Drover JW, et al. J Am Coll Surg. 2011;212:385–99.
Strong for surgery nutrition checklist. Available at www.strongforsurgery.org. 2014.
Almeida, A et al. Nutritional Screening in Surgery: Valid, Feasible, Easy. Clin Nutr. 31(2012):206–11.
Abrahao V. Nourishing the dysfunctional gut with whey protein. Curr Opin Clin Nutr Metab Care. 2012;15:480–4.
Scaldaferri F. Gut microbial flora, prebiotics, and probiotics in IBD: their current usage and utility. BioMed Res Int. Article ID 435268. 2013.
Shoda R, et al. Epidemiologic analysis of Crohn’s disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn’s disease in Japan. Am J Clin Nutr. 1996;63:741–5.
Goh J. Review article: nutrition and adult inflammatory bowel disease. Aliment Pharmacol Ther. 2003;17:307–20.
Gottschall E. Breaking the vicious cycle intestinal health through diet. Ontario, Canada. The Kirkton Press. 1994.
Suskind D, et al. Nutritional therapy in pediatric Crohn disease: the specific carbohydrate diet. J Pediatr Gastroenterol Nutr. 2014;58(1):87–92.
Kanai T, et al. Diet, microbiota, and inflammatory bowel disease: lessons from Japanese foods. Korean J Intern Med. 2014;29(4):409–15.
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Javelli, D.R. (2015). Diet and Nutrition in the Treatment of Crohn’s Disease. In: Fichera, A., Krane, M. (eds) Crohn’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-14181-7_21
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DOI: https://doi.org/10.1007/978-3-319-14181-7_21
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