Chronic intestinal failure and short bowel syndrome in Crohn’s disease

Table 3 Nutrition therapy (macronutrients) according to presence or absence of colon (modified from Pironi et al[46], 2016)

Nutrient	Colon present (partial/complete)	Colon removed or disabled
Carbo-hydrates	Slow increase of the proportion of complex carbohydrates up to approx. 40%-50% of total calorie intake, no low molecular weight sugars	Slowly increase the proportion of complex carbohydrates up to approx. 40%-50% of total calorie intake, no low molecular weight sugars, modified FODMAP diet
Protein	Up to 20%-30% of total energy intake	Protein: up to 20%-30% of total energy intake
Fat	Up to 20%-30% of total energy intake	Fat: up to 40% of total energy intake
	Ensure adequate essential fatty acids (high EFA content)	Ensure adequate essential fatty acids (high EFA content)
	Consider MCTs	Limit MCTs
Fiber	Dietary fiber supplements: up to 5-10 g/d	Dietary fiber supplements: up to 5-10 g/d
Oxalate	Diet low in oxalic acid and fats; Replacement of up to 50%-75% of dietary fat with MCTs	No restriction of oxalic acid necessary
Fluids	Even if liquids are well tolerated, iso- and hypotonic drinks are preferable	Oral rehydration solutions frequently required
Lactose	Low lactose diet (10-12 g)	Unrestricted lactose intake

EFA: Essential fatty acids; FODMAP: Fermentable oligo-, di-, monosaccharides and polyols diet; MCT: Medium-chain triglyceride.