British Dietetic Association evidence‐based guidelines for the dietary management of Crohn's disease in adults. Issue 3 (6th December 2013)

• Record Type: Journal Article
• Authors: Lee, J.; Allen, R.; Ashley, S.; Becker, S.; Cummins, P.; Gbadamosi, A.; Gooding, O.; Huston, J.; Le Couteur, J.; O'Sullivan, D.; Wilson, S.; Lomer, M. C. E.; Gastroenterology Specialist Group of the British Dietetic Association
• Is Part Of: Journal of human nutrition and dietetics. Volume 27:Issue 3(2014)
• Page Start: 207
• Page End: 218
• Publication Date: 2013-12-06
• Subjects: Dietetics -- Periodicals; Nutrition -- Periodicals; 613.205
• DOI: 10.1111/jhn.12176
• Languages: English
• ISSNs: 0952-3871

Abstract

<abstract abstract-type="main" id="jhn12176-abs-0001"> <title>Abstract</title> <sec id="jhn12176-sec-0001" sec-type="section"> <title>Background</title> <p>Crohn's disease is a debilitating chronic inflammatory bowel disease. Appropriate use of diet and nutritional therapy is integral to the overall management strategy of Crohn's disease. The aim was to develop evidence‐based guidelines on the dietary management of Crohn's disease in adults.</p> </sec> <sec id="jhn12176-sec-0002" sec-type="section"> <title>Methods</title> <p>Questions relating to the dietary management of Crohn's disease were developed. These included the roles of enteral nutrition to induce remission, food re‐introduction diets to structure food re‐introduction and maintain remission, and dietary management of stricturing disease, as well as whether probiotics or prebiotics induce or maintain remission. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines CINAHL, Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science. Evidence statements, recommendations, practical considerations and research recommendations were developed.</p> </sec> <sec id="jhn12176-sec-0003" sec-type="section"> <title>Results</title> <p>Fifteen research papers were critically appraised and the evidence formed the basis of these guidelines. Although corticosteroids appear to be more effective, enteral nutrition (elemental or non‐elemental) can be offered as an alternative option to induce disease remission. After a course of enteral nutrition, food re‐introduction diets may be useful to structure food re‐introduction and help maintain disease remission. Dietary fibre is contraindicated in the presence of strictures as a result of the risk of mechanical obstruction. The use of probiotics and prebiotics is not currently supported.</p> </sec> <sec id="jhn12176-sec-0004" sec-type="section"> <title>Conclusions</title> <p>As an alternative to corticosteroids, evidence supports enteral nutrition to induce disease remission. Food re‐introduction diets provide structure to food re‐introduction and help maintain disease remission. These guidelines aim to reduce variation in clinical practice.</p> </sec> </abstract>