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小儿炎症性肠病的饮食管理。

Dietary Management of Pediatric Inflammatory Bowel Disease.

机构信息

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Rush University Children's Hospital, Chicago, Illinois, USA.

出版信息

J Med Food. 2019 Nov;22(11):1092-1099. doi: 10.1089/jmf.2019.0063. Epub 2019 Jul 18.

Abstract

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a life-long relapsing and remitting condition characterized by inflammation of the intestine. While the exact pathogenesis of IBD is unclear, the current belief is that both genetic and environmental factors play a role in development of disease. Management options include nutritional, pharmacological, and surgical therapies. In particular, nutritional therapies for IBD have garnered significant interest due to their limited side effect profile, bowel-sparing nature, and naturalistic approach. This review will examine the role of diet in the pathogenesis and malnutrition in IBD, and will discuss dietary approaches to management of IBD, including exclusive enteral nutrition, specific carbohydrate diet, anti-inflammatory diet, and food supplements (specifically curcumin and long-chain 3 polyunsaturated fatty acids). Past and recent literature on these subjects were reviewed in Medhub and Scopus databases for this review article with a focus on pediatric and high-quality publications. At this time, these approaches seem to be safe and show promise of an efficacious sole or supplemental role in the treatment of IBD, but randomized, prospective studies are lacking. Additional studies investigating these diets and food supplements are needed to provide more information on their efficacy, mechanism, applicability, and safety.

摘要

炎症性肠病(IBD)包括克罗恩病和溃疡性结肠炎,是一种终身复发和缓解的疾病,其特征是肠道炎症。虽然 IBD 的确切发病机制尚不清楚,但目前认为遗传和环境因素都在疾病的发展中起作用。治疗选择包括营养、药物和手术治疗。特别是,由于 IBD 的营养治疗具有副作用小、保留肠道和自然的特点,因此引起了广泛关注。本文将探讨饮食在 IBD 的发病机制和营养不良中的作用,并讨论 IBD 的饮食管理方法,包括肠内营养、特殊碳水化合物饮食、抗炎饮食和膳食补充剂(特别是姜黄素和长链 3 多不饱和脂肪酸)。为了撰写这篇综述文章,我们在 Medhub 和 Scopus 数据库中回顾了这些主题的过去和最近的文献,重点是儿科和高质量的出版物。目前,这些方法似乎是安全的,并有望在 IBD 的治疗中发挥有效的单一或补充作用,但缺乏随机前瞻性研究。需要进一步研究这些饮食和膳食补充剂,以提供更多关于其疗效、机制、适用性和安全性的信息。

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