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Nutrition and ulcerative colitis
A Burke1, G R Lichtenstein, J L Rombeau
1Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Bailliere'S Clinical Gastroenterology
|March 1, 1997
Summary
Dietary interventions and nutrient supplementation show promise for managing ulcerative colitis (UC). Nutritional support is crucial, with enteral nutrition preferred over parenteral, and specific nutrients may aid treatment and reduce cancer risk in UC patients.
Area of Science:
- Gastroenterology
- Nutritional Science
- Inflammatory Bowel Disease Research
Background:
- The precise role of diet in ulcerative colitis (UC) etiology and pathogenesis is unclear.
- Impaired butyrate utilization by colonocytes, potentially linked to sulfur-fermenting bacteria, may be significant.
- Oxidative stress likely contributes to tissue injury but may not be a primary cause.
Purpose of the Study:
- To review the current understanding of diet's role in ulcerative colitis (UC).
- To evaluate the efficacy of various nutritional therapies and supplements in managing UC.
- To assess the impact of nutrients on UC-related complications, including malnutrition and cancer risk.
Main Methods:
- Literature review of studies on diet, nutrition, and ulcerative colitis.
- Analysis of evidence for enteral versus parenteral nutrition in UC management.
- Evaluation of specific nutrient interventions such as butyrate, fiber, fatty acids, and antioxidants.
Main Results:
- Patients with UC often experience malnutrition; adequate nutrition is vital, especially peri-operatively.
- Enteral nutrition is the preferred route over parenteral nutrition for most UC patients.
- Butyrate enemas, fiber supplements, eicosapentaenoic acid, gamma-linolenic acid, and antioxidants show potential benefits.
- Nutrients may play a role in mitigating the increased colorectal cancer risk associated with UC.
Conclusions:
- Nutritional management is a critical component of ulcerative colitis care.
- Enteral nutrition and specific nutrient supplementation can be beneficial as adjuvant therapies.
- Careful monitoring and supplementation of micronutrients (e.g., calcium, vitamin D, folate) are necessary for patients with UC, particularly those on long-term medications.