Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb 28;2014(2):CD006320.
doi: 10.1002/14651858.CD006320.pub4.

Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease

Raffi Lev-Tzion, Anne Marie Griffiths, Oren Leder, Dan Turner

Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease

Raffi Lev-Tzion et al. Cochrane Database Syst Rev. .

Abstract

Background: The anti-inflammatory effects of n-3 (omega-3 fatty acids, fish oil) have been suggested to be beneficial in chronic inflammatory disorders such as inflammatory bowel disease. This review is an update of a previously published Cochrane review.

Objectives: To systematically review the efficacy and safety of n-3 for maintenance of remission in Crohn's disease (CD).

Search methods: The following databases were searched from inception to November 2013 without language restriction: CENTRAL, MEDLINE, EMBASE, HealthSTAR, PubMed, and ACP journal club.

Selection criteria: Randomized placebo-controlled trials (RCT) of n-3 for maintenance of remission in CD were included. Studies must have enrolled patients of any age group, who were in remission at the time of recruitment, and were followed for at least six months. The intervention must have been fish oil or n-3 given in pre-defined dosage. Co-interventions were allowed only if they were balanced between the study groups.

Data collection and analysis: The primary outcome was the relapse rate and secondary outcomes included change in disease activity scores, time to first relapse and adverse events. Two independent investigators reviewed studies for eligibility, extracted the data and assessed study quality using the Cochrane risk of bias tool. The overall quality of the evidence supporting the primary and selected secondary outcomes was reassessed for the current update using the GRADE system. We used the RevMan software for analyses. We calculated the risk ratio (RR) and corresponding 95% confidence interval (CI) for dichotomous outcomes and the hazard ratio and 95% CI for time-to-event outcomes. Random-effects or fixed-effect models were used according to degree of heterogeneity and sensitivity analyses were performed in an attempt to explore possible sources of heterogeneity.

Main results: Six studies with a total of 1039 patients were eligible for inclusion. The two largest studies were rated as low risk of bias for all assessed items. Four studies were rated as unclear risk of bias for randomization and allocation concealment. Two studies were rated as high risk of bias for incomplete outcome data and selective reporting. There was a marginal significant benefit of n-3 therapy for maintenance of remission. Thirty-nine per cent of patients in the n-3 group relapsed at 12 months compared to 47% of placebo patients (6 studies, 1039 patients; RR 0.77, 95% CI 0.61 to 0.98). A GRADE analysis rated the overall quality of the evidence for the primary outcome (i.e. relapse) as very low due to unexplained heterogeneity (I2 = 58%), publication bias, and a high or unknown risk of bias in four studies in the pooled analysis. When two large studies at low risk of bias were considered the benefit was no longer statistically significant. Thirty-seven per cent of patients in the n-3 group relapsed at 12 months compared to 42% of placebo patients (2 studies, 738 patients; RR 0.88, 95% CI 0.74 to 1.05). No significant heterogeneity was identified for this pooled analysis ( I2 = 0%). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was moderate due to sparse data (294 events). No serious adverse events were recorded in any of the studies but in a pooled analyses there was a significantly higher rate of diarrhea (4 studies, 862 patients; RR 1.36 95% CI 1.01 to 1.84) and upper gastrointestinal tract symptoms (5 studies, 999 patients; RR 1.65, 95% CI 1.25 to 2.18) in the n-3 treatment group.

Authors' conclusions: Evidence from two large high quality studies suggests that omega 3 fatty acids are probably ineffective for maintenance of remission in CD. Omega 3 fatty acids appear to be safe although they may cause diarrhea and upper gastrointestinal tract symptoms.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
1.1
1.1. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 1 Relapse rate at one year (all studies).
1.2
1.2. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 2 Relapse rate at one year (enteric coated studies).
1.3
1.3. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 3 Relapse rate at one year (sensitivity analysis of Belluzi 1996).
1.4
1.4. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 4 Relapse rate at one year (enteric coated ‐ risk difference).
1.5
1.5. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 5 Relapse rate at one year (sensitivity analysis ‐ excluding abstract study).
1.6
1.6. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 6 Relapse rate at one year (sensitivity analysis ‐ excluding pediatric study).
1.7
1.7. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 7 Relapse rate at one year (all studies, rate in EPIC studies by survival estimates).
1.8
1.8. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 8 Relapse rate at one year (only EPIC studies).
1.9
1.9. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 9 Relapse at one year, survival analysis (Hazard Ratios of the EPIC studies).
1.10
1.10. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 10 Adverse events rate: Diarrhea.
1.11
1.11. Analysis
Comparison 1 Omega‐3 versus placebo, Outcome 11 Adverse events rate: Upper GI symptoms (nausea, vomiting, halitosis, heartburn, dyspepsia, disgeusia and bloating).
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Belluzzi 1996 {published data only}
    1. Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of an enteric‐coated fish‐oil preparation on relapses in Crohn's disease. New England Journal of Medicine 1996;334(24):1557‐60. - PubMed
Belluzzi 1997 {published data only}
    1. Belluzzi A, Campieri M, Belloli C, Boschi S, Cottone M, Rizzello F, et al. A new enteric coated preparation of omega‐3 fatty acids for preventing post‐surgical recurrence in Crohn's disease. Gastroenterology 1997;112(4):A494.
Feagan 2008a {published data only}
    1. Feagan BG, Sandborn WJ, Mittmann U, Bar‐Meir S, D'Haens G, Bradette M, et al. Omega‐3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials. JAMA 2008;299(14):1690‐7. - PubMed
Feagan 2008b {published data only}
    1. Feagan BG, Sandborn WJ, Mittmann U, Bar‐Meir S, D'Haens G, Bradette M, et al. Omega‐3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials. JAMA 2008;299(14):1690‐7. - PubMed
Lorenz‐Meyer 1996 {published data only}
    1. Lorenz‐Meyer H, Bauer P, Nicolay C, Schulz B, Purrmann J, Fleig WE, et al. Omega‐3 fatty acids and low carbohydrate diet for maintenance of remission in Crohn's disease. A randomized controlled multicenter trial. Study Group Members (German Crohn's Disease Study Group). Scandinavian Journal of Gastroenterology 1996;31(8):778‐85. - PubMed
Romano 2005 {published data only}
    1. Romano C, Cucchiara S, Barabino A, Annese V, Sferlazzas C. Usefulness of omega‐3 fatty acid supplementation in addition to mesalazine in maintaining remission in pediatric Crohn's disease: a double‐blind, randomized, placebo‐controlled study. World Journal of Gastroenterology 2005;11(45):7118‐21. - PMC - PubMed

References to studies excluded from this review

Bamba 2003 {published data only}
    1. Bamba T, Shimoyama T, Sasaki M, Tsujikawa T, Fukuda Y, Koganei K, et al. Dietary fat attenuates the benefits of an elemental diet in active Crohn's disease: a randomized, controlled trial. European Journal of Gastroenterology and Hepatology 2003;15(2):151‐7. - PubMed
Bjorkkjaer 2004 {published data only}
    1. Bjorkkjaer T, Brunborg LA, Arslan G, Lind RA, Brun JG, Valen M, et al. Reduced joint pain after short‐term duodenal administration of seal oil in patients with inflammatory bowel disease: comparison with soy oil. Scandinavian Journal of Gastroenterology 2004;39(11):1088‐94. - PubMed
Eivindson 2005 {published data only}
    1. Eivindson M, Gronbaek H, Nielsen JN, Frystyk J, Flyvbjerg A, Jorgensen L, et al. Insulin‐like growth factors (IGFs) and IGF binding proteins in active Crohn's disease treated with omega‐3 or omega‐6 fatty acids and corticosteroids. Scandinavian Journal of Gastroenterology 2005;40(10):1214‐21. - PubMed
Geerling 2000 {published data only}
    1. Geerling BJ, Badart‐Smook A, Deursen C, Houwelingen AC, Russel MG, Stockbrugger RW, et al. Nutritional supplementation with N‐3 fatty acids and antioxidants in patients with Crohn's disease in remission: effects on antioxidant status and fatty acid profile. Inflammatory Bowel Diseases 2000;6(2):77‐84. - PubMed
Lorenz 1989 {published data only}
    1. Lorenz R, Weber PC, Szimnau P, Heldwein W, Strasser T, Loeschke K. Supplementation with n‐3 fatty acids from fish oil in chronic inflammatory bowel disease‐‐a randomized, placebo‐controlled, double‐blind cross‐over trial. Journal of Internal Medicine. Supplement 1989;731:225‐32. - PubMed
Mate 1991 {published data only}
    1. Mate J, Castanos R, Garcia‐Samaniego J, Pajares JM. Does dietary fish oil maintain the remission of Crohn's disease (CD): A case control study. Gastroenterology 1991;100(5):A228.
Nielsen 2005 {published data only}
    1. Nielsen AA, Jorgensen LG, Nielsen JN, Eivindson M, Gronbaek H, Vind I, et al. Omega‐3 fatty acids inhibit an increase of proinflammatory cytokines in patients with active Crohn's disease compared with omega‐6 fatty acids. Alimentary Pharmacology and Therapeutics 2005;22(11‐12):1121‐8. - PubMed
Sakurai 2002 {published data only}
    1. Sakurai T, Matsui T, Yao T, Takagi Y, Hirai F, Aoyagi K, et al. Short‐term efficacy of enteral nutrition in the treatment of active Crohn's disease: a randomized, controlled trial comparing nutrient formulas. JPEN. Journal of Parenteral and Enteral Nutrition 2002;26(2):98‐103. - PubMed
Seidman 2003 {published data only}
    1. Seidman E, Bouthillier L, Thibault L, Lepage G, Chartre M, Deslandres C, et al. Clinical and nutritional parameters in Crohn's disease patients treated with either an n‐3 PUFA‐enriched semi‐elemental or a polymeric diet. Results of a randomized controlled trial. Journal of Pediatric Gastroenterology and Nutrition 2003;37(3):393.
Socha 2002 {published data only}
    1. Socha P, Ryzko J, Koletzko B, Czubkowski P, Korszynska D, Celinska‐Cedro D, et al. The influence of fish oil therapy in children with inflammatory bowel disease on the fatty acid status. Pediatria Wspolczesna 2002;4(3):413‐6.
Trebble 2004 {published data only}
    1. Trebble TM, Arden NK, Wootton SA, Calder PC, Mullee MA, Fine DR, et al. Fish oil and antioxidants alter the composition and function of circulating mononuclear cells in Crohn disease. American Journal of Clinical Nutrition 2004;80(5):1137‐44. - PubMed
Trebble 2005 {published data only}
    1. Trebble TM. Bone turnover and nutritional status in Crohn's disease: relationship to circulating mononuclear cell function and response to fish oil and antioxidants. Proceedings of the Nutrition Society 2005;64(2):183‐91. - PubMed
Tsujikawa 2000 {published data only}
    1. Tsujikawa T, Satoh J, Uda K, Ihara T, Okamoto T, Araki Y, et al. Clinical importance of n‐3 fatty acid‐rich diet and nutritional education for the maintenance of remission in Crohn's disease. Journal of Gastroenterology 2000;35(2):99‐104. - PubMed

Additional references

Akabas 2006
    1. Akabas SR, Deckelbaum RJ. Summary of a workshop on n‐3 fatty acids: current status of recommendations and future directions. American Journal of Clinical Nutrition 2006;83(6 Suppl):1536S‐8S. - PubMed
Arterburn 2006
    1. Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n‐3 fatty acids in humans. American Journal of Clinical Nutrition 2006;83(6 Suppl):1467S‐76S. - PubMed
Bassaganya‐Riera 2006
    1. Bassaganya‐Riera J, Hontecillas R. CLA and n‐3 PUFA differentially modulate clinical activity and colonic PPAR‐responsive gene expression in a pig model of experimental IBD. Clinical Nutrition 2006;25(3):454‐65. - PubMed
Belluzzi 1994
    1. Belluzzi A, Brignola C, Campieri M, Camporesi EP, Gionchetti P, Rizzello F, et al. Effects of new fish oil derivative on fatty acid phospholipid‐membrane pattern in a group of Crohn's disease patients. Digestive Diseases and Sciences 1994;39(12):2589‐94. - PubMed
Belluzzi 2002
    1. Belluzzi A. N‐3 fatty acids for the treatment of inflammatory bowel diseases. Proceedings of the Nutrition Society 2002;61(3):391‐5. - PubMed
Best 1976
    1. Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology 1976;70(3):439‐44. - PubMed
Deckelbaum 2006
    1. Deckelbaum RJ, Worgall TS, Seo T. N‐3 fatty acids and gene expression. American Journal of Clinical Nutrition 2006;83(6 Suppl):1520S‐5S. - PubMed
el Boustani 1987
    1. Boustani S, Colette C, Monnier L, Descomps B, Crastes de Paulet A, Mendy F. Enteral absorption in man of eicosapentaenoic acid in different chemical forms. Lipids 1987;22(10):711‐4. - PubMed
Endres 1989
    1. Endres S, Ghorbani R, Kelley VE, Georgilis K, Lonnemann G, Meer JW, et al. The effect of dietary supplementation with n‐3 polyunsaturated fatty acids on the synthesis of interleukin‐1 and tumor necrosis factor by mononuclear cells. New England Journal of Medicine 1989;320(5):265‐71. - PubMed
Endres 1999
    1. Endres S, Lorenz R, Loeschke K. Lipid treatment of inflammatory bowel disease. Current Opinion in Clinical Nutrition and Metabolic Care 1999;2(2):117‐20. - PubMed
Ergas 2002
    1. Ergas D, Eilat E, Mendlovic S, Sthoeger ZM. N‐3 fatty acids and the immune system in autoimmunity. Israel Medical Association Journal 2002;4(1):34‐8. - PubMed
Figler 2007
    1. Figler M, Gasztonyi B, Cseh J, Horvath G, Kisbenedek AG, Bokor S, et al. Association of n‐3 and n‐6 long chain polyunsaturated fatty acids in plasma lipid classes with inflammatory bowel diseases. British Journal of Nutrition 2007;97(6):1154‐61. - PubMed
Fisher 1986
    1. Fisher M, Upchurch KS, Levine PH, Johnson MH, Vaudreuil CH, Natale A, et al. Effects of dietary fish oil supplementation on polymorphonuclear leukocyte inflammatory potential. Inflammation 1986;10(4):387‐92. - PubMed
Guyatt 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924‐6. - PMC - PubMed
Guyatt 2011
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction ‐ GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383‐94. - PubMed
Harvey 1980
    1. Harvey RF, Bradshaw JM. A simple index of Crohn's‐disease activity. Lancet 1980;1(8167):514. - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hillier 1991
    1. Hillier K, Jewell R, Dorrell L, Smith CL. Incorporation of fatty acids from fish oil and olive oil into colonic mucosal lipids and effects upon eicosanoid synthesis in inflammatory bowel disease. Gut 1991;32(10):1151‐5. - PMC - PubMed
Hokari 2013
    1. Hokari R, Matsunaga H, Miura S. Effect of dietary fat on intestinal inflammatory diseases. Journal of Gastroenterology and Hepatology 2013;28 Suppl 4:33‐6. - PubMed
Hooper 2004
    1. Hooper L, Thompson RL, Harrison RA, Summerbell CD, Moore H, Worthington HV, et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database of Systematic Reviews 2004, Issue 4. [DOI: 10.1002/14651858.CD003177.pub2] - DOI - PMC - PubMed
Hyams 1991
    1. Hyams JS, Ferry GD, Mandel FS, Gryboski JD, Kibort PM, Kirschner BS, et al. Development and validation of a pediatric Crohn's disease activity index. Journal of Pediatric Gastroenterology and Nutrition 1991;14(4):439‐47. - PubMed
Kandiel 2005
    1. Kandiel A, Fraser AG, Korelitz BI, Brensinger C, Lewis JD. Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6‐mercaptopurine. Gut 2005;54(8):1121‐5. - PMC - PubMed
Kim 1996
    1. Kim YI. Can fish oil maintain Crohn's disease in remission?. Nutrition Reviews 1996;54(8):248‐52. - PubMed
Kuroki 1997
    1. Kuroki F, Iida M, Matsumoto T, Aoyagi K, Kanamoto K, Fujishima M. Serum n3 polyunsaturated fatty acids are depleted in Crohn's disease. Digestive Diseases and Sciences 1997;42(6):1137‐41. - PubMed
Lawson 1988
    1. Lawson LD, Hughes BG. Human absorption of fish oil fatty acids as triacylglycerols, free acids, or ethyl esters. Biochemical and Biophysical Research Communications 1988;152(1):328‐35. - PubMed
Lee 1985
    1. Lee TH, Hoover RL, Williams JD, Sperling RI, Ravalese J 3rd, Spur BW, et al. Effect of dietary enrichment with eicosapentaenoic and docosahexaenoic acids on in vitro neutrophil and monocyte leukotriene generation and neutrophil function. New England Journal of Medicine 1985;312(19):1217‐24. - PubMed
MacLean 2005
    1. MacLean CH, Mojica WA, Newberry SJ, Pencharz J, Garland RH, Tu W, et al. Systematic review of the effects of n‐3 fatty acids in inflammatory bowel disease. American Journal of Clinical Nutrition 2005;82(3):611‐9. - PubMed
Marion‐Letellier 2013
    1. Marion‐Letellier R, Savoye G, Beck PL, Panaccione R, Ghosh S. Polyunsaturated fatty acids in inflammatory bowel diseases: a reappraisal of effects and therapeutic approaches. Inflammatory Bowel Diseases 2013;19(3):650‐61. - PubMed
Matsunaga 2008
    1. Matsunaga H, Hokari R, Kurihara C, Okada Y, Takebayashi K, Okudaira K, et al. Omega‐3 fatty acids exacerbate DSS‐induced colitis through decreased adiponectin in colonic subepithelial myofibroblasts. Inflammatory Bowel Diseases 2008;14(10):1348‐57. - PubMed
Meister 2005
    1. Meister D, Ghosh S. Effect of fish oil enriched enteral diet on inflammatory bowel disease tissues in organ culture: differential effects on ulcerative colitis and Crohn's disease. World Journal of Gastroenterology 2005;11(47):7466‐72. - PMC - PubMed
Melanson 2005
    1. Melanson SF, Lewandrowski EL, Flood JG, Lewandrowski KB. Measurement of organochlorines in commercial over‐the‐counter fish oil preparations: implications for dietary and therapeutic recommendations for omega‐3 fatty acids and a review of the literature. Archives of Pathology and Laboratory Medicine 2005;129(1):74‐7. - PubMed
Nakazawa 2000
    1. Nakazawa A, Hibi T. Is fish oil (n‐3 fatty acids) effective for the maintenance of remission in Crohn's disease?. Journal of Gastroenterology 2000;35(2):173‐5. - PubMed
Nieto 2002
    1. Nieto N, Torres MI, Rios A, Gil A. Dietary polyunsaturated fatty acids improve histological and biochemical alterations in rats with experimental ulcerative colitis. Journal of Nutrition 2002;132(1):11‐9. - PubMed
Oh 2005
    1. Oh R. Practical applications of fish oil (Omega‐3 fatty acids) in primary care. Journal of the American Board of Family Practice 2005;18(1):28‐36. - PubMed
Roy 2007
    1. Roy N, Barnett M, Knoch B, Dommels Y, McNabb W. Nutrigenomics applied to an animal model of Inflammatory Bowel Diseases: Transcriptomic analysis of the effects of eicosapentaenoic acid‐and arachidonic acid‐enriched diets. Mutation Research 2007;622(1‐2):103‐16. - PubMed
Ruxton 2004
    1. Ruxton CH, Reed SC, Simpson MJ, Millington KJ. The health benefits of omega‐3 polyunsaturated fatty acids: a review of the evidence. Journal of Human Nutrition and Dietetics 2004;17(5):449‐59. - PubMed
Schünemann 2011
    1. Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Siguel 1996
    1. Siguel EN, Lerman RH. Prevalence of essential fatty acid deficiency in patients with chronic gastrointestinal disorders. Metabolism 1996;45(1):12‐23. - PubMed
Simopoulos 2002
    1. Simopoulos AP. Omega‐3 fatty acids in inflammation and autoimmune diseases. Journal of the American College of Nutrition 2002;21(6):495‐505. - PubMed
Socha 2005
    1. Socha P, Ryzko J, Koletzko B, Celinska‐Cedro D, Woynarowski M, Czubkowski P, et al. Essential fatty acid depletion in children with inflammatory bowel disease. Scandinavian Journal of Gastroenterology 2005;40(5):573‐7. - PubMed
Thayu 2005
    1. Thayu M, Markowitz JE, Mamula P, Russo PA, Muinos WI, Baldassano RN. Hepatosplenic T‐cell lymphoma in an adolescent patient after immunomodulator and biologic therapy for Crohn disease. Journal of Pediatric Gastroenterology and Nutrition 2005;40(2):220‐2. - PubMed
Turner 2012
    1. Turner D, Griffiths AM, Walters TD, Seah T, Markowitz J, Pfefferkorn M, et al. Mathematical weighting of the pediatric Crohn's disease activity index (PCDAI) and comparison with its other short versions. Inflammatory Bowel Diseases 2012;18(1):55‐62. - PubMed
Vilaseca 1990
    1. Vilaseca J, Salas A, Guarner F, Rodriguez R, Martinez M, Malagelada JR. Dietary fish oil reduces progression of chronic inflammatory lesions in a rat model of granulomatous colitis. Gut 1990;31(5):539‐44. - PMC - PubMed
Woodworth 2010
    1. Woodworth HL, McCaskey SJ, Duriancik DM, Clinthorne JF, Langohr IM, Gardner EM, et al. Dietary fish oil alters T lymphocyte cell populations and exacerbates disease in a mouse model of inflammatory colitis. Cancer Research 2010;70(20):7690‐9. - PubMed
Zachos 2007
    1. Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2007, Issue 1. [DOI: 10.1002/14651858.CD000542.pub2] - DOI - PubMed

References to other published versions of this review

Turner 2007
    1. Turner D, Zlotkin SH, Shah PS, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2007, Issue 2. [DOI: 10.1002/14651858.CD006320.pub2] - DOI - PubMed
Turner 2009
    1. Turner D, Zlotkin SH, Shah PS, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease.. Cochrane Database of Systematic Reviews 2009, Issue 1. [DOI: 10.1002/14651858.CD006320.pub3] - DOI - PubMed

Publication types