Español
Polski
English
українська
A recordar
Recomendaciones sobre la modificación de la dieta de los pacientes con enfermedad de Crohn (EC)
1. Los pacientes con EC no deben consumir productos lácteos no pasteurizados.
2. Parece razonable recomendar a los pacientes con EC:
- un consumo entre moderado y alto de frutas y verduras, y a los enfermos sintomáticos o con estenosis gastrointestinales significativas, limitar el consumo de fibra insoluble
- limitar el consumo de alimentos que contienen maltodextrina, edulcorantes artificiales, carragenano, carboximetilcelulosa, polisorbato 80, dióxido de titanio y sulfitos
- seguir una dieta con bajo contenido en oligosacáridos, disacáridos, monosacáridos y polioles fermentables (baja en FODMAP), si los síntomas de la enfermedad persisten a pesar de la remisión de la inflamación y no hay estenosis gastrointestinales.
Recomendaciones sobre la modificación de la dieta de los pacientes con colitis ulcerosa (CU)
1. Los enfermos con CU no deben consumir productos lácteos no pasteurizados.
2. Parece razonable recomendar a los pacientes con CU:
- reducir el consumo de carne roja y procesada
- limitar el consumo de ácido mirístico (aceite de palma, aceite de coco, grasas de productos lácteos) y grasas trans, y aumentar el consumo de ácidos grasos omega-3 (eicosapentaenoico [EPA] y docosahexaenoico [DHA]) procedentes de pescado de mar, pero no de suplementos nutricionales
- limitar el consumo de alimentos que contienen maltodextrina, edulcorantes artificiales, carragenano, carboximetilcelulosa, polisorbato 80, dióxido de titanio y sulfitos
- seguir una dieta con bajo contenido en oligosacáridos, disacáridos, monosacáridos y polioles fermentables (baja en FODMAP) si los síntomas de la enfermedad persisten a pesar de la remisión de la inflamación gastrointestinal.
Bibliografía:
1. Zhang Y.Z., Li Y.Y., Inflammatory bowel disease: pathogenesis, World J. Gastroenterol., 2014; 20: 91-992. Abegunde A.T., Muhammad B.H., Bhatti O. y cols., Environmental risk factors for inflammatory bowel diseases: evidence based literature review, World J. Gastroenterol., 2016; 22: 6296-6317
3. Desai M.S., Seekatz A.M., Koropatkin N.M. y cols., A dietary fiberdeprived gut microbiota degrades the colonic mucus barrier and enhances pathogen susceptibility, Cell, 2016; 167: 1339-1353
4. Ritchie J.K., Wadsworth J., Lennard-Jones J.E. y cols., Controlled multicentre therapeutic trial of an unrefined carbohydrate, fibre rich diet in Crohn’s disease, Br. Med. J. (Clin. Res. Ed.), 1987; 295: 517-520
5. Brotherton C.S., Martin C.A., Long M.D. y cols., Avoidance of fiber is associated with greater risk of Crohn’s disease flare in a 6-month period, Clin. Gastroenterol. Hepatol., 2016; 14: 1130-1136
6. Magee E.A., Edmond L.M., Tasker S.M. y cols., Associations between diet and disease activity in ulcerative colitis patients using a novel method of data analysis, Nutr. J., 2005; 4: 7
7. Cohen S.A., Gold B.D., Oliva S. y cols., Clinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn disease, J. Pediatr. Gastroenterol. Nutr., 2014; 59: 516-521
8. Junker Y., Zeissig S., Kim S.J. y cols., Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4, J. Exp. Med., 2012; 209: 2395-2408
9. Barnes E.L., Nestor M., Onyewadume L. y cols., High dietary intake of specific fatty acids increases risk of flares in patients with ulcerative colitis in remission during treatment with aminosalicylates, Clin. Gastroenterol. Hepatol., 2017; 15: 1390-1396
10. Albenberg L.G., Brensinger C.M., Wu Q. y cols., A Diet Low in Red and Processed Meat Does Not Reduce Rate of Crohn’s Disease Flares, Gastroenterology, 2019; 157:128-136.
11. Jowett S.L., Seal C.J., Pearce M.S. y cols., Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study, Gut, 2004; 53: 1479-1484
12. Strisciuglio C., Giannetti E., Martinelli M. y cols., Does cow’s milk protein elimination diet have a role on induction and maintenance of remission in children with ulcerative colitis?, Acta Paediatr., 2013; 102: 273-278
13. Levine A., Wine E., Assa A. y cols., Crohn’s Disease Exclusion Diet plus partial enteral nutrition induces sustained remission in a randomized controlled trial, Gastroenterology, 2019; 157: 440-450
14. Grimstad T., Berge R.K., Bohov P. y cols., Salmon diet in patients with active ulcerative colitis reduced the simple clinical colitis activity index and increased the anti-inflammatory fatty acid index: a pilot study, Scand. J. Clin. Lab. Invest., 2011; 71: 68-73
15. Chiyama K., Nakamura M., Odahara S. y cols., N-3 poly unsaturated fatty acid diet therapy for patients with inflammatory bowel disease, Inflamm. Bowel Dis., 2010;16:1696-1707
16. Cabré E., Manosa M., Gassull M.A., Omega-3 fatty acids and inflammatory bowel diseases– a systematic review, Br. J. Nutr., 2012;107 (supl. 2):S240-S52
17. Feagan B.G., Sandborn W.J., Mittmann U. y cols., Omega-3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials, JAMA, 2008; 299: 1690-1697
18. Turner D., Shah P.S., Steinhart A.H. y cols., Maintenance of remission in inflammatory bowel disease using omega-3 fatty acids (fish oil): a systematic review and meta-analyses, Inflamm. Bowel Dis., 2011;17:336-345
19. Nickerson K.P., McDonald C., Crohn’s disease-associated adherent-invasive Escherichia coli adhesion is enhanced by exposure to the ubiquitous dietary polysaccharide maltodextrin, PLoS One, 2012; 7: 52 132
20. Al-Suhail A.A., Reid P.E., Culling C.F. y cols., Studies of the degraded carrageenan-induced colitis of rabbits. I. Changes in the epithelial glycoprotein O-acylated sialic acids associated with ulceration, Histochem. J., 1984; 16: 543-553
21. Devkota S., Wang Y., Musch M.W. y cols., Dietary-fat-induced taurocholic acid promotes pathobiont expansion and colitis in Il10–/– mice, Nature, 2012; 487: 104-108
22. Lomer M.C., Harvey R.S., Evans S.M. y cols., Efficacy and tolerability of a low microparticle diet in a double blind, randomized, pilot study in Crohn’s disease, Eur. J. Gastroenterol. Hepatol., 2001; 13: 101-106
23. Lomer M.C., Grainger S.L., Ede R. y cols., Lack of efficacy of a reduced microparticle diet in a multi-centred trial of patients with active Crohn’s disease, Eur. J. Gastroenterol. Hepatol., 2005; 17: 377-384
