Guagnozzi Danila, González-Castillo Sonia, Olveira Antonio, Lucendo Alfredo J
Rev Esp Enferm Dig. 2012 Sep;104(9):479-88. doi: 10.4321/s1130-01082012000900006.
enteral (EN) and parenteral (TPN) nutrition exert variable therapeutic effects on the induction and maintenance of remission in inflammatory bowel disease (IBD). This review aims to provide an updated discussion on the complex relationship between diet and IBD.
medline, Cochrane and Scopus database searches were conducted. Sources cited in the articles obtained were also searched to identify other potential sources of information.
nutritional status is significantly compromised in IBD patients, especially those with Crohn's disease (CD). Apart from restoring malnourishment, dietary components contribute to modulate intestinal immune responses. Nutritional treatment is divided into support therapy and primary therapy to induce and maintain remission through TPN and EN. EN is considered a first-line therapy in children with active CD whereas it is usually used in adult CD patients when corticosteroid therapy is not possible. TPN has limited effects on IBD.En formula composition, in terms of carbohydrates, nitrogen source and bioactive molecules supplementation, differentially influence on IBD treatment outcomes. Other dietary components, such as poorly absorbed short-chain carbohydrate, polyols, and exogenous microparticles, also participate in the etiopathogenesis of IBD. Finally, new approaches to understanding the complex relationship between IBD and diet are provided by nutrigenenomic.
further long-term, well-powered studies are required to accurately assess the usefulness of nutrition in treating IBD. In future research, the potential role of nutrient-gene interaction in drug trials and specific dietary formula compositions should be investigated in order to incorporate new knowledge about the etiopathology of IBD into nutritional intervention.
肠内营养（EN）和肠外营养（TPN）对炎症性肠病（IBD）缓解的诱导和维持具有不同的治疗效果。本综述旨在对饮食与IBD之间的复杂关系进行更新讨论。
进行了Medline、Cochrane和Scopus数据库检索。还对所获文章中引用的来源进行了检索，以识别其他潜在信息来源。
IBD患者，尤其是克罗恩病（CD）患者的营养状况显著受损。除了恢复营养不良外，饮食成分有助于调节肠道免疫反应。营养治疗分为支持治疗和通过TPN及EN诱导和维持缓解的主要治疗。EN被认为是儿童活动性CD的一线治疗方法，而在成人CD患者中，当无法进行皮质类固醇治疗时通常使用。TPN对IBD的作用有限。EN配方组成，在碳水化合物、氮源和生物活性分子补充方面，对IBD治疗结果有不同影响。其他饮食成分，如吸收不良的短链碳水化合物、多元醇和外源性微粒，也参与IBD的发病机制。最后，营养基因组学为理解IBD与饮食之间的复杂关系提供了新方法。
需要进一步开展长期、有力的研究，以准确评估营养在治疗IBD中的作用。在未来的研究中，应研究营养-基因相互作用在药物试验和特定饮食配方组成中的潜在作用，以便将关于IBD发病机制的新知识纳入营养干预。
