Nutrition as Essential Treatment in Inflammation-An Updated Review Article

Abstract

Background: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic, immune-mediated disorder characterized by inflammation of the gastrointestinal tract. The relationship between diet, gut microbiota, and immune response is increasingly recognized as a key factor in the development and management of IBD. The Western diet, rich in fats, sugars, and additives, is thought to contribute to IBD progression. This review investigates dietary interventions aimed at modulating gut inflammation, focusing on their role in managing IBD.

Aim: This article aims to evaluate the effectiveness of dietary treatments, such as Exclusive Enteral Nutrition (EEN), Partial Enteral Nutrition (PEN), and the Crohn's Disease Exclusion Diet (CDED), in managing IBD, specifically focusing on their impact on inflammation, microbiota composition, and clinical outcomes.

Methods: A comprehensive search was conducted on clinical trial registries and the PUBMED database to identify relevant studies on dietary interventions for IBD. The review includes trials comparing dietary therapies to standard treatments, placebos, and other interventions, with a focus on clinical remission, mucosal healing, and microbial alterations.

Results: EEN has shown strong efficacy in inducing remission in pediatric CD patients, with higher mucosal healing rates compared to corticosteroids. While PEN combined with CDED has demonstrated similar remission rates to EEN, it offers advantages in patient tolerance and long-term management. Additionally, dietary changes were associated with shifts in gut microbiota, particularly a decrease in microbial diversity and changes in specific bacterial species, which are linked to clinical improvement.

Conclusion: Dietary interventions, especially EEN and PEN with CDED, are promising treatments for IBD, offering significant benefits in managing inflammation and promoting mucosal healing. Further research is needed to optimize these dietary strategies for both short- and long-term management of IBD.