Barnes Edward L, Beniwal-Patel Poonam, Deepak Parakkal, Raffals Laura, Kayal Maia, Dubinsky Marla, Chang Shannon, Higgins Peter D R, Barr Jennifer I, Anderson Chelsea, Cross Raymond K, Long Millie D, Herfarth Hans H
Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA.
Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA.
Crohns Colitis 360. 2023 Jul 27;5(3):otad039. doi: 10.1093/crocol/otad039. eCollection 2023 Jul.
Evidence-based recommendations regarding the influence of diet on inflammatory conditions of the pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are limited.
We analyzed dietary patterns at enrollment in a prospective registry of patients with 1 of 4 inflammatory conditions of the pouch (acute pouchitis, chronic antibiotic-dependent pouchitis, chronic antibiotic refractory pouchitis, and Crohn's disease of the pouch). We analyzed dietary intake by disease activity at enrollment and then compared dietary patterns among patients who remained in remission throughout the 12-month follow-up to those patients who experienced a disease relapse. We also compared dietary patterns among patients with inflammatory conditions of the pouch to the United States Department of Agriculture (USDA) recommended daily goals.
Among 308 patients, there were no differences in dietary patterns among patients with 1 of the 4 disease states at enrollment. Additionally, among the 102 patients in remission at baseline, there were no significant differences noted among patients who went on to experience a disease flare in the 12 months after enrollment compared to those patients who remained in remission. However, patients with inflammatory conditions of the pouch demonstrated decreased intake of several food groups and macronutrients including dairy, fruits, vegetables, whole grains, and fiber when compared to USDA recommendations.
In a prospective cohort, we demonstrated no impact of dietary patterns on disease activity. The relative deficiencies in several food groups and macronutrients among patients after IPAA indicate the potential role of targeted nutritional counseling in this population.
关于饮食对回肠储袋肛管吻合术（IPAA）后储袋炎症性疾病影响的循证推荐有限。
我们分析了一个前瞻性登记处中患有4种储袋炎症性疾病之一（急性储袋炎、慢性抗生素依赖型储袋炎、慢性抗生素难治型储袋炎和储袋克罗恩病）患者入组时的饮食模式。我们按入组时的疾病活动度分析饮食摄入量，然后比较在12个月随访期间一直处于缓解期的患者与经历疾病复发的患者的饮食模式。我们还将患有储袋炎症性疾病的患者的饮食模式与美国农业部（USDA）推荐的每日目标进行了比较。
在308名患者中，入组时患有4种疾病状态之一的患者的饮食模式没有差异。此外，在基线时处于缓解期的102名患者中，入组后12个月内经历疾病发作的患者与那些保持缓解的患者之间没有显著差异。然而，与USDA的建议相比，患有储袋炎症性疾病的患者对包括乳制品、水果、蔬菜、全谷物和纤维在内的几种食物组和宏量营养素的摄入量有所减少。
在一个前瞻性队列中，我们证明饮食模式对疾病活动没有影响。IPAA术后患者中几种食物组和宏量营养素的相对缺乏表明了针对性营养咨询在该人群中的潜在作用。
