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World J Gastroenterol. Mar 28, 2010; 16(12): 1442-1448
Published online Mar 28, 2010. doi: 10.3748/wjg.v16.i12.1442
Role of diet in the management of inflammatory bowel disease
Nirooshun Rajendran, Devinder Kumar
Nirooshun Rajendran, Devinder Kumar, Department of General Surgery, 3rd Floor, St James Wing, St George’s Hospital, London, SW17 0QT, United Kingdom
Author contributions: Rajendran N wrote the manuscript; Kumar D reviewed the drafts and made significant revisions.
Correspondence to: Devinder Kumar, Professor, PhD, FRCS, Consultant Colorectal and General Surgeon, Department of General Surgery, 3rd Floor, St James Wing, St George’s Hospital, Blackshaw Road, Tooting, London, SW17 0QT, United Kingdom.
Telephone: +44-208-7251302 Fax: +44-208-7253611
Received: November 15, 2009
Revised: December 24, 2009
Accepted: December 31, 2009
Published online: March 28, 2010

Many studies have looked at connections between diet, etiology, signs and symptoms associated with inflammatory bowel disease (IBD). Although these connections are apparent to clinicians, they are difficult to prove qualitatively or quantitatively. Enteral feeding and polymeric diets are equally effective at bringing about remission in Crohn’s disease (CD). Parenteral feeding is also effective, although none of these methods is as effective as corticosteroid therapy. However, enteral feeding is preferred in the pediatric population because linear growth is more adequately maintained via this route. Exclusion diets in patients brought into remission using an elemental diet have been shown to maintain remission for longer periods. Studies that aim to isolate culpable food groups have shown that individuals react differently on exposure to or exclusion of various foods. The commonly identified food sensitivities are cereals, milk, eggs, vegetables and citrus fruits. Studies that have looked at gut mucosal antigen behavior have shown higher rectal blood flow, in response to specific food antigens, in those with CD over healthy subjects. Exclusion of sugar shows little evidence of amelioration in CD. Omega 3 fatty acids show promise in the treatment of IBD but await larger randomized controlled trials. Patients frequently notice that specific foods cause aggravation of their symptoms. Whilst it has been difficult to pinpoint specific foods, with advances in the laboratory tests and food supplements available, the aim is to prolong remission in these patients using dietary measures, and reduce the need for pharmacotherapy and surgical intervention.

Keywords: Crohn’s disease, Ulcerative colitis, Exclusion diet, Elimination diet