Inflammatory bowel disease comprises several diagnoses with bowel inflammation, the most common of which are Crohn's disease and ulcerative colitis. These diseases are associated with malnutrition, including protein-calorie malnutrition, vitamin deficiency and mineral deficiencies. Various dietary practices have been implicated as attempts have been made to determine the etiologies of these diseases. Nutritional support of patients with inflammatory bowel disease has been directed toward serving as a primary therapy, correcting nutritional deficiencies and correction of growth failure.
There have been numerous reviews of inflammatory bowel disease and nutrition over the years. These, for the most part, vary regarding concepts of nutritional management of Crohn's disease, depending on whether the reviews have originated in the United States or Europe. This chapter will concentrate primarily on the literature from the past decade, as well as some of the older, but classical references on the topic.
In inflammatory bowel disease (IBD) as in many gastrointestinal diseases, the disease itself may have a profound effect on an individual's nutritional status. In some intestinal diseases there may be a role for dietary practices in the pathogenesis of the disease. Additionally, nutrition and manipulation of food intake may alter the course of the disease. This review will concentrate initially on the nutritional consequences of Crohn's disease and chronic ulcerative colitis. The possible effects of diet and lifestyle in the etiology of IBD will be addressed. Finally, the use of nutrition support and special diets in the treatment of IBD will be discussed.
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