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Nutrition in Crohn's disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

In general, there are no specific foods that have to be avoided by the Crohn's patient. Patients should try and eat a balanced diet and avoid food which upsets them. However, in particular situations then dietary modification is necessary:

  • high fibre foods, e.g. fruit and vegetables, may precipitate abdominal pain in some patients - especially those with small intestinal disease. In this group of patients a low residue diet, e.g. avoidance of vegetables, brown bread may bring symptomatic relief
  • low fat diets: if steatorrhoea is a main complaint
  • exclusion diet: this is as reliable as corticosteroids in producing remission in acute disease - success rate as high as 90%; however, most patients relapse soon after the resumption of a normal diet
  • fish oil - there is evidence that enteric-coated fish oil preparations may reduce relapse rate and maintain remission in patients with Crohn's disease
    • the anti-inflammatory omega-3-polyunsaturated fatty acids (PUFAs) from fish oils - 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.
    • probiotics are live non-pathogenic organisms such as various Lactobacillus species, which aim to confer health benefits by improving the gut micro-organism environment (1)
  • vitamins and minerals: if there are specific nutritional deficiencies
  • malnourishment: if the patient has active disease or is perioperative then parenteral nutrition may be indicated

dietary measures for inducing remission in Crohn's disease (4)

  • enteral nutrition should be considered as an alternative to a conventional glucocorticosteroid to induce remission for:
    • children in whom there is concern about growth or side effects, and young people in whom there is concern about growth

Reference:

  1. Prescriber (2004); 15(5).
  2. Riordan, A.M. et al. (1993). Treatment of active Crohn's disease by exclusion diet: East Anglian Multicentre Controlled Trial. Lancet; 342: 1131-34.
  3. Belluzzi A et al (1996). Effect of enteric-coated fish oil preparation on relapses in Crohn's disease. NEJM;334: 1557-60.
  4. NICE (May 2019). Crohn's disease Management in adults, children and young people

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