Diet as a treatment for inflammatory bowel disease: is it ready for prime time?

Abstract

Purpose of review: Diet remains an important topic for patients with inflammatory bowel disease (IBD), yet few guidelines for dietary recommendations exist. There is a growing interest in the use of diet as treatment or adjuvant therapy for both ulcerative colitis and Crohn's disease. Here, we highlight the latest evidence on the use of diet for treatment of symptoms, active disease and maintenance of remission in ulcerative colitis and Crohn's disease.

Recent findings: The Crohn's Disease Exclusion Diet (CDED) and the Specific Carbohydrate Diet (SCD) are studied diets that have gained popularity, but there is growing interest in the use and efficacy of less restrictive diets such as the Mediterranean diet. Recent data suggest healthful dietary patterns alone, with an emphasis on whole foods that are high in vegetable fibre and that promote less consumption of ultra-processed foods may also help achieve remission in patients with ulcerative colitis and Crohn's disease.

Summary: In this review, we summarize the literature on diet as treatment for IBD. We highlight the latest clinical dietary studies, randomized clinical trials, as well as new and emerging diets for the treatment of IBD.

Figure 1:. Practical Guidance on Dietary Counseling for Providers.

Advising patients on diet is difficult in a busy clinic setting. Here we present a basic framework for dietary counseling for providers for patients recently diagnosed with inflammatory bowel disease. Highlighted are additional resources available for both providers and patients and appropriate screening recommendations for patients who may meet criteria for malnutrition. (IBD = Inflammatory Bowel Disease, CDED = Crohn’s Disease Exclusion Diet, CD = Crohn’s disease, UC = ulcerative colitis, IBS = irritable bowel syndrome, FODMAP = fermentable oligosaccharides, disaccharides, monosaccharides, and polyols)