New nutritional approach to inflammatory bowel disease: the nutraceuticals

  • Marina Taus
  • Debora Busni
  • Massimiliano D. Petrelli
  • Albano Nicolai


The clinical course of inflammatory bowel disease (IBD) is characterised by periods of quiescent disease interspersed with episodes of active inflammation; consequently, malabsorption and malnutrition are the most important problems in IBD patients. It has been widely demonstrated that nutritional support allows more tolerability both to drugs and surgery therapy increases the duration of remission. Among enteral formula enriched in specific nutraceuticals like glutamine or transforming growth factor β2 used in IBD, we tested those enriched with omega 3, soluble fibre and arginine. We observed a high compliance and a statistically significant improvement of symptoms, nutritional status, inflammatory index and Crohn’s disease activity index. A specific nutritional intervention, in particular specific enteral nutrition formula, is essential in the prevention and treatment of malnutrition caused by IBD.

Key words

Inflammatory bowel disease Enteral nutrition Nutraceuticals Artificial nutrition 


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  1. 1.
    Bach JF (2002) The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 347:911–920CrossRefGoogle Scholar
  2. 2.
    Danese S, Sans M, Fiocchi C (2004) Inflammatory bowel disease: the role of environmental factors. Autoimmun Rev 3:394–400CrossRefGoogle Scholar
  3. 3.
    Latella G, Viscido A, Frieri G (1998) L’intestino nei pazienti critici (prima parte). Giornale di Gastroenterologia 3:70–102Google Scholar
  4. 4.
    Elson CO (1988) The immunology of inflammatory bowel disease. In: Kirsner JB, Shorter RG (eds) Inflammatory bowel disease. Lea & Febiger, Philadelphia, pp 97–1742Google Scholar
  5. 5.
    Fraquelli M, Maloni G, Colucci A (2000) Aggiornarsi in rete: inflammatory bowel diseases (IBD). Springer-VerlagGoogle Scholar
  6. 6.
    Tsujikawa T, Andoh A, Fujiyama Y (2003) Enteral and parenteral nutrition therapy for Crohn’s disease. Curr Pharm Des 9:323–332CrossRefGoogle Scholar
  7. 7.
    Goh J, O’Morain CA (2003) Review article: nutrition and adult inflammatory bowel disease. Aliment Pharmacol Ther 17:307–320CrossRefGoogle Scholar
  8. 8.
    Beattie RM, Bentsen BS, MacDonald TT (1998) Childhood Crohn’s disease and the efficacy of enteral diets. Nutrition 14:345–350CrossRefGoogle Scholar
  9. 9.
    Escher JC, Taminiau JA (2001) Treatment of inflammatory bowel disease in childhood. Scand J Gastroenterol Suppl 234:48–50CrossRefGoogle Scholar
  10. 10.
    Hiwatashi N (1997) Enteral nutrition for Crohn’s disease in Japan. Dis Colon Rectum 40[Suppl 10]:S48–53 (Review)CrossRefGoogle Scholar
  11. 11.
    Jeejeebhoy KN (1999) Nutrition vs drug therapy. In: Bistrian BR, Walker Smith JA (eds) Inflammatory bowel diseases. Karger, pp 139–154Google Scholar
  12. 12.
    Giaffer MH, North G, Holdsworth CD (1990) Controlled trial of polymeric vs elemental diet in treatment of active Crohn’s disease. Lancet 335:816–819CrossRefGoogle Scholar
  13. 13.
    Zochos M, Tandeur M, Griffiths AM (2007) Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev CD000542Google Scholar
  14. 14.
    Bamba T, Shimoyama T, Sasaki M et al (2003) Dietary fat attenuates the benefits of an elemental diet in active Crohn’s disease: a randomized, controlled trial. Eur J Gastroenterol Hepatol 15:115–118CrossRefGoogle Scholar
  15. 15.
    Belluzzi A, Brignola C, Campieri M et al (1996) Effect of an enteric-coated fish-oil preparation on relapses in Crohn’s disease. N Engl J Med 334:1557–1560CrossRefGoogle Scholar
  16. 16.
    Nieto N, Torres MI, Ríos A, Gil A (2002) Dietary polyunsaturated fatty acids improve histological and biochemical alterations in rats with experimental ulcerative colitis. J Nutr 132:11–19Google Scholar
  17. 17.
    Nielsen AA, Jørgensen LG, Nielsen JN et al (2005) Omega 3 fatty acids inhibit an increase of proinflammatory cytokines in patients with active Crohn’s disease compared with omega 6 fatty acids. Aliment Pharmacol Ther 22:1121–1128CrossRefGoogle Scholar
  18. 18.
    Taus M, Peruzzi E, Petrelli M et al (2005) Utilizzo delle miscele enterali arricchite in nutriceutici nelle malattie infiammatorie croniche intestinali. Riv Ital Nutr Paren Ent 23(3):(Abstract)Google Scholar
  19. 19.
    Grimble RF (2005) Immunonutrition. Curr Opin Gastroenterol 21:216–222CrossRefGoogle Scholar
  20. 20.
    Taus M, Busni D, Petrelli M (2007) Immunomodulazione nei pazienti affetti da Morbo di Crohn. Nutrition Therapy and Metabolism SINPE News, p 50Google Scholar
  21. 21.
    Coeffier M, Le Pessot F, Leplingard A et al (2002) Acute enteral glutamine infusion enhances heme oxygenase-1 expression in human duodenal mucosa. J Nutr 132:2570–2573Google Scholar
  22. 22.
    Coeffier M, Miralles-Barrachina O, Le Pessot F et al (2001) Influence of glutamine on cytokine production by human gut in vitro. Cytokine 13:148–154CrossRefGoogle Scholar
  23. 23.
    Akobeng AK, Miller V, Stanton J et al (2000) Double-blind randomized controlled trial of glutamine-enriched polymeric diet in the treatment of active Crohn’s disease. J Pediatr Gastroenterol Nutr 30:78–84CrossRefGoogle Scholar
  24. 24.
    Den-Hond E, Hiele M, Peeters M et al (1999) Effect of long-term oral glutamine supplements on small intestinal permeability in patients with Crohn’s disease. J Parenter Enteral Nutr 23:7–11CrossRefGoogle Scholar
  25. 25.
    Fell JM, Paintin M, Arnaud-Battandier F et al (2000) Mucosal healing and a fall in mucosal pro-inflammatory cytokine mRNA induced by a specific oral polymeric diet in paediatric Crohn’s disease. Aliment Pharmacol Ther 14:281–289CrossRefGoogle Scholar
  26. 26.
    Fiocchi C (2001) TGF-β Smad signaling defects in inflammatory bowel disease: mechanisms and possible novel therapies for chronic inflammation. J Clin Invest 108:523–526Google Scholar
  27. 27.
    Shanahan F (2000) Probiotics and inflammatory bowel disease: is there a scientific rationale? Inflamm Bowel Dis 6:107–115Google Scholar
  28. 28.
    Mack DR, Michail S, Wei S et al (1999) Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am J Physiol 276:G941–950Google Scholar
  29. 29.
    Madsen KL (1999) Lactobacillus species prevents colitis in interleukin 10 gene-deficient mice. Gastroenterology 116:1107–1114CrossRefGoogle Scholar
  30. 30.
    O’Mahony L, Feeney M, O’Halloran S et al (2001) Probiotic impact on microbial flora, inflammation and tumour development in IL-10 knockout mice. Aliment Pharmacol Ther 15:1219CrossRefGoogle Scholar
  31. 31.
    Kruis W, Schütz E, Fric P et al (1997) Double-blind comparison of an oral Escherichia Coli preparation and mesalazine in maintaining remission of ulcerative colitis. Aliment Pharmacol Ther 11:853–858CrossRefGoogle Scholar
  32. 32.
    Venturi A, Gionchetti P, Rizzello F et al (1999) Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 13:1103–1108CrossRefGoogle Scholar
  33. 33.
    Madsen K, Cornish A, Soper P et al (2001) Probiotic bacteria enhance murine and human intestinal epithelial barrier function. Gastroenterology 121:580–591CrossRefGoogle Scholar
  34. 34.
    Gionchetti P, Rizzello F, Venturi A et al (2000) Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 119:305–309CrossRefGoogle Scholar
  35. 35.
    Kuhbacher T, Ott SJ, Scheriber S et al (2006) Bacterial and fungal microbiota in relation to probiotic therapy (VSL#3) in pouchitis. Gut 55:833–841CrossRefGoogle Scholar
  36. 36.
    Lindsay JO, Whelan K, Stagg AJ et al (2006) Clinical, microbiological, and immunological effects of fructo-oligosaccaride in patients with Crohn’s disease. Gut 55:348–355CrossRefGoogle Scholar
  37. 37.
    Spapen H, Diltoer M, Van Malderen C et al (2001) Soluble fiber reduces the incidence of diarrhea in septic patients receiving total enteral nutrition: a prospective, double blind, randomized, and controlled trial. Clin Nutr 20:301–305CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Marina Taus
    • 1
  • Debora Busni
    • 1
  • Massimiliano D. Petrelli
    • 1
  • Albano Nicolai
    • 1
  1. 1.SOD di Dietetica e Nutrizione ClinicaAOU Ospedali Riuniti AnconaAnconaItaly

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