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Nutrition in ulcerative colitis

Authoring team

Points of note with respect to the diet of those with ulcerative colitis:

  • neither elemental diets nor hyperalimentation with bowel rest are of benefit in ulcerative colitis, unlike in Crohn's disease.

  • fish oil, or other forms of eicosapentanoic acids:
    • these divert arachidonic acid metabolites away from the pro-inflammatory leukotriene B4 to less inflammatory leukotrienes
    • various studies have shown the potential to modulate luminal and tissue eicosanoids in ulcerative colitis and to allow reduction of steroid therapy. However, long-term benefits have yet to been shown
    • the importance of dietary intake of PUFA has been gleaned from epidemiological observations that Eskimos have a low incidence of inflammatory bowel disease (IBD)

  • probiotics - there is ongoing interest in the use of probiotics in the treatment of IBD.
    • is effective in maintaining remission in UC (1)
    • probiotics are live non-pathogenic organisms such as various Lactobacillus species, which aim to confer health benefits by improving the gut micro-organism environment

The European Society for Parenteral and Enteral Nutrition published the Guidelines for Clinical Nutrition Management of Inflammatory Bowel Disease, which confirm the remission-inducing effect of specific probiotic strains in patients with mild to moderate UC, with the use of Lactobacillus reuteri and VSL#3 being recommended (2)

 

Reference:

  1. World Gastroenterology Organisation. Global guidelines: inflammatory bowel disease. Aug 2015 [internet publication].
  2. Forbes A. et al. (2019). Corrigendum to “ESPEN guideline: clinical nutrition in inflammatory bowel disease” [clinical nutrition 36 (2017) 321-347]. Clin. Nutr. 38:1486.

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