Nutritional and metabolic issues in inflammatory bowel disease

Area of Science:

• Gastroenterology
• Nutritional Science
• Metabolic Research

Background:

• Inflammatory bowel disease (IBD) is associated with significant nutritional and metabolic complications.
• Understanding these derangements is crucial for effective patient management and therapeutic development.

Purpose of the Study:

• To review clinical papers published in 2002-2003 concerning nutritional and metabolic disturbances in IBD.
• To synthesize current findings on growth factors, bone metabolism, dietary interventions, and novel therapies in IBD.

Main Methods:

• Literature review of clinical studies on IBD published in 2002 and early 2003.
• Analysis of research on growth factors, metabolic bone disease, enteral feeding, probiotics, and body composition in IBD patients.

Main Results:

• Insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) are reduced in IBD, with limited reversal by therapy.
• Recombinant human growth hormone shows promise in pediatric IBD. Metabolic bone disease remains debated.
• Low-fat enteral diets, potentially with medium-chain triglycerides, are effective for Crohn's disease. Probiotics (VSL#3) show efficacy in pouchitis.

Conclusions:

• IBD-related growth hormone-IGF-1 axis disturbances are poorly responsive to standard therapy.
• The roles of inflammation and steroids in IBD-associated metabolic bone disease require further clarification.
• Dietary fat composition and the use of probiotics/prebiotics offer promising therapeutic avenues for IBD.