inflammatory%20bowel%20disease
INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease consists of ulcerative colitis and Crohn's disease.
Ulcerative colitis is a diffuse mucosal inflammation limited to the colon while Crohn's disease is a patchy, transmural inflammation that occurs in any part of the gastrointestinal tract.
The ileum and colon are the most frequently affected sites.

Patient Education

  • Audiovisual or suitable written information on IBD should be given
  • Stress the importance of adherence to therapy

Lifestyle Modification

Nutrition and Lifestyle Modification for Ulcerative Colitis
  • Cessation of smoking may prevent flaring of symptoms in patients with UC
  • Stress management programs may aid in the patients’ overall disease outlook
  • Patients are prone to malnutrition and may suffer detrimental effects from it
    • Decrease fiber intake during increased disease activity to reduce frequency of bowel movements
    • High fiber diets to be given only for those with involvement limited to the rectum
  • Nutritional support is adjunctive in patients who are malnourished or have a difficult time maintaining normal nutritional status and should also be considered in those with intestinal partial obstruction awaiting surgery
  • Prebiotics and probiotics have no clear evidence on its role as adjunctive therapy
  • Routine multivitamin supplementation for all patients
  • Routine vit D and Ca supplementation for those under steroid therapy
  • Iron supplementation, either oral or parenteral, for those with chronic iron deficiency

Nutrition and Lifestyle Modification for Crohn's Disease
  • Smoking cessation should be strongly advised
  • Stress management programs may aid in the patients’ overall disease outlook
  • Patients are prone to malnutrition and may suffer detrimental effects from it
    • Decrease fiber intake during increased disease activity to reduce frequency of bowel movements
    • Placing the patient on NPO, or giving only liquid diet or pre-digested formula may decrease obstructive symptoms
  • Elemental or polymeric diets may be used to induce remission in some patients with active CD who have contraindications to corticosteroids or where patients prefer to avoid corticosteroids
    • May reduce inflammatory features of active CD; although, long-term course of the disease is not altered
      • Cost and compliance may be a limiting factor
    • May be attempted as adjunctive therapy to support patient’s nutrition
  • Exclusive enteral nutrition is used as disease modifying therapy for growth failure
    • Usually given for 3-6 weeks
  • Nutritional support is adjunctive in patients who are malnourished or have a difficult time maintaining normal nutritional status, and should also be considered in those with intestinal partial obstruction awaiting surgery
  • Prebiotics and probiotics have no clear evidence on its role as adjunctive therapy
  • Routine multivitamin supplementation for all patients
  • Routine vit D and Ca supplementation for those under steroid therapy
  • Iron supplementation, either oral or parenteral, for those with chronic iron deficiency
  • Vit B12 supplementation for deficiency states at 1000 mcg SC every month 
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