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Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 7, 2009; 15(21): 2570-2578
Published online Jun 7, 2009. doi: 10.3748/wjg.15.2570
Nutritional status and nutritional therapy in inflammatory bowel diseases
Corina Hartman, Rami Eliakim, Raanan Shamir
Corina Hartman, Raanan Shamir, Institute of Gastro-enterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach-Tikva 49202, Israel
Rami Eliakim, Institute of Gastroenterology, Rambam Health Care Campus, Rappaport School of Medicine, Technion Institute, Haifa 31096, Israel
Author contributions: Hartman C wrote the manuscript; Eliakim R and Shamir R reviewed the paper.
Correspondence to: Corina Hartman, Institute of Gastro-enterology, Nutrition, and Liver Disease, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach-Tikva 49202, Israel. corinahartman@gmail.com
Telephone: +972-3-9253672
Fax: +972-3-9253104
Received: February 19, 2009
Revised: April 20, 2009
Accepted: April 27, 2009
Published online: June 7, 2009
Abstract

Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease (IBD). In addition, a significant number of children with IBD, especially Crohn’s disease (CD) have impaired linear growth. Nutrition has an important role in the management of IBD. In adults with CD, enteral nutrition (EN) is effective in inducing clinical remission of IBD, although it is less efficient than corticosteroids. Exclusive EN is an established primary therapy for pediatric CD. Limited data suggests that EN is as efficient as corticosteroids for induction of remission. Additional advantages of nutritional therapy are control of inflammation, mucosal healing, positive benefits to growth and overall nutritional status with minimal adverse effects. The available evidence suggests that supplementary EN may be effective also for maintenance of remission in CD. More studies are needed to confirm these findings. However, EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in CD. EN does not have a primary therapeutic role in ulcerative colitis. Specific compositions of enteral diets-elemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further evaluation. Recent theories suggest that diet may be implicated in the etiology of IBD, however there are no proven dietary approaches to reduce the risk of developing IBD.

Keywords: Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis; Adults; Children; Malnutrition; Growth disorders; Nutrition therapy