Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada.
Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada; Service de gastroentérologie, Hôpital St-Luc, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada; Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Clin Nutr. 2018 Jun;37(3):884-889. doi: 10.1016/j.clnu.2017.03.010. Epub 2017 Mar 15.
BACKGROUND & AIMS: Patients with inflammatory bowel diseases avoid a variety of foods. However, it remains unclear how this behavior varies across patients. This cross-sectional study investigated how the food avoidance pattern in inflammatory bowel disease varies according to disease's activity, disease's subtype, Crohn's location, and prior history of bowel resection, strictures, and fistulae.
Outpatients with Crohn's disease (n = 173) and ulcerative colitis (n = 72) reported which food they avoid when they perceive they are in remission or in active disease using a list of 82 food items classified in 10 categories. Medical charts were reviewed for patients' characteristics. Linear regression analyses were used to compare food exclusion rates between patients' subgroups and food categories.
During remission, food exclusion rates varied from 1 to 39%. Most avoided foods were those with capsaicin, meat alternatives, and raw vegetables. Overall, food exclusion rates were 38% higher in Crohn's disease than ulcerative colitis (P < 0.001), and 50% higher in stricturing than non-stricturing Crohn's disease (P < 0.001). During active disease, food exclusion rates were 69% higher than in remission (P < 0.001). Similar differences between subgroups were again observed during active disease though less noticeable than in remission. No association was found with other disease characteristics. Avoided foods were very similar across patients except for alcoholic beverages and foods rich in dietary fibers/residue, which were avoided more specifically during active disease and in Crohn's disease, respectively.
Food avoidance is common among patients with inflammatory bowel diseases, and most particularly in those with stricturing Crohn's disease. Specificities in avoidance pattern suggest that the clinical response to dietary restrictions may differ according to the disease's characteristics.
患有炎症性肠病的患者会避免食用多种食物。然而，目前尚不清楚这种行为在不同患者之间有何差异。本横断面研究旨在调查炎症性肠病患者的食物回避模式如何根据疾病的活动程度、疾病的亚型、克罗恩病的位置以及既往肠切除术、狭窄和瘘管史而有所不同。
采用 82 种食物清单，将其分为 10 类，收集处于缓解期或活动期的克罗恩病（n=173）和溃疡性结肠炎（n=72）患者的食物回避模式。通过回顾病历了解患者的特征。采用线性回归分析比较患者亚组和食物类别之间的食物排除率。
在缓解期，食物排除率从 1%到 39%不等。最常被回避的食物是含辣椒素、肉类替代品和生蔬菜。总体而言，克罗恩病患者的食物排除率比溃疡性结肠炎患者高 38%（P<0.001），狭窄型克罗恩病患者比非狭窄型克罗恩病患者高 50%（P<0.001）。在活动期，食物排除率比缓解期高 69%（P<0.001）。在活动期也观察到类似的亚组差异，但比缓解期不那么明显。与其他疾病特征无关联。除了酒精饮料和富含膳食纤维/残渣的食物外，患者在缓解期和活动期的回避食物非常相似，但在活动期和克罗恩病患者中更具体地回避这些食物。
炎症性肠病患者常回避食物，尤其是患有狭窄型克罗恩病的患者。回避模式的特异性表明，对饮食限制的临床反应可能因疾病特征而异。
