The role of diet in inflammatory bowel disease: A comprehensive review of the literature

Abstract

Diet is increasingly recognized as a modifiable factor in the pathogenesis and management of inflammatory bowel disease (IBD), particularly in mild to moderate cases. While most evidence comes from pediatric studies, adult data, especially randomized controlled trials (RCTs), remain limited. Current guidelines recommend a Mediterranean diet for patients with IBD, avoiding fruits and vegetables during disease flares. Exclusive enteral nutrition (EEN) has demonstrated therapeutic potential in pediatric Crohn's disease (CD), but data in adults are less conclusive, partly due to issues with adherence. Clinicians must routinely monitor nutritional markers such as hemoglobin, iron status, vitamins, and albumin every 6-12 months, and supplement deficiencies as required. The presence of a dedicated nutrition specialist within IBD units could improve care, as nutrition also impacts psychological well-being. In addition, the role of the microbiome and how dietary interventions can modulate it to alleviate both inflammatory and functional symptoms warrant further exploration.

Keywords: Crohn's disease; Diet; Inflammatory bowel disease; Nutrition; Ulcerative colitis.