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World J Gastroenterol. Jan 21, 2016; 22(3): 1045-1066
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1045
Advances in nutritional therapy in inflammatory bowel diseases: Review
Andrzej Wędrychowicz, Andrzej Zając, Przemysław Tomasik
Andrzej Wędrychowicz, Department of Pediatrics, Gastroenterology and Nutrition, Polish-American Children’s Hospital, Jagiellonian University Medical College, 30663 Krakow, Poland
Andrzej Zając, Department of Pediatric Surgery, Polish-American Children’s Hospital, Jagiellonian University Medical College, 30663 Krakow, Poland
Przemysław Tomasik, Department of Clinical Biochemistry, Polish-American Children’s Hospital, Jagiellonian University Medical College, 30663 Krakow, Poland
Author contributions: Wędrychowicz A, Zając A and Tomasik P contributed equally to this paper.
Conflict-of-interest statement: Authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Andrzej Wędrychowicz, MD, PhD, Department of Pediatrics, Gastroenterology and Nutrition, Polish-American Children’s Hospital, Jagiellonian University Medical College, 265 Wielicka Street, 30663 Krakow, Poland. andrzej.wedrychowicz@uj.edu.pl
Telephone: +48-12-6582011 Fax: +48-12-6581088
Received: April 24, 2015
Peer-review started: April 26, 2015
First decision: June 2, 2015
Revised: July 22, 2015
Accepted: September 13, 2015
Article in press: September 22, 2015
Published online: January 21, 2016
Processing time: 265 Days and 17.4 Hours
Abstract

Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are suspected as triggering factors in the etiopathogenesis of IBD. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility in different populations and in different countries is not clearly established, and there are sometimes conflicting theories concerning the role of nutrition in IBD. This review presents the actual data from research studies on the influence of nutrition on the etiopathogenesis of IBD and the latest findings regarding its mechanisms of action. The use of both parenteral and enteral nutrition as therapeutic methods in induction and maintenance therapy in IBD treatment is also extensively discussed. Comparison of the latest research data, scientific theories concerning the role of nutrition in IBD, and different opinions about them are also presented and discussed. Additionally, some potential future perspectives for nutritional therapy are highlighted.

Keywords: Dietary factors; Etiology; Nutritional therapy; Parenteral nutrition; Exclusive enteral nutrition; Induction therapy; Maintenance therapy; Inflammatory bowel disease

Core tip: Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility is not clearly established, and the evidence is sometimes conflicting. This review presents the latest findings of research studies regarding the influence of nutrition on the etiopathogenesis of IBD, its mechanisms of action, and its use as a therapeutic method. Additionally, some potential future perspectives for nutritional therapy are highlighted.