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Abstract

Patients with inflammatory bowel disease (IBD) often ask their doctors about diet. This review provides the existing dietary advice by: 1) listing the medical societies clinical practice guidelines for IBD; 2) listing dietary guidelines from patientcentered IBD-related organizations, and 3) creating a new ?Global Practice Guideline? which attempts to consolidate the existing information. Dietary suggestions include nutrient deficiency screening, avoiding foods that worsen symptoms, eating smaller meals at more frequent intervals, drinking adequate fluids, avoiding caffeine and alcohol, taking vitamin/mineral supplementation, eliminating dairy if lactose intolerant, limiting excess fat, reducing carbohydrates, and reducing high-fiber foods during flares. Mixed advice exists regarding probiotics. Enteral nutrition is recommended for adult Crohn?s disease patients in Japan, which differs from practices in the United States. In addition, The Specific Carbohydrate Diet (SCD) is reviewed in terms of summarizing the clinical studies testing the SCD?s efficacy in reducing gastrointestinal symptoms. A PubMed search revealed limited clinical studies, but suggested a trend toward carbohydrate restricted diets (under 100 grams or limiting certain carbohydrate types) to benefit certain inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) symptoms. Possible mechanisms include minimizing: 1) inflammation, 2) digestive enzyme disruption, 3) food sensitivities or adverse food reactions, 4) digestive demands, 5) bacterial food sources, 6) gut stress, and 7) microbial dysbiosis. A complete elimination diet incorporating carbohydrate restriction needs to be researched to determine if it benefits IBD and IBS patients.

Biography

Amy Brown, PhD, RD, received her Doctorate in Human Nutrition and Foods from Virginia Tech. She is as an Associate Professor professor at the University of Hawaii in the John A. Burns School of Medicine?s Department of Complementary and Alternative Medicine. Her clinical and bench research focuses on Medical Nutrition Therapy as it relates to foods that may hold therapeutic potential for disease. She has authored 33 scientific publications in the field of human nutrition including the American Dietetic Association position paper on Functional Foods. She authored ?Understanding Food,? the number one best selling college textbook in its field.