scholarly journals Carbohydrate Monotony as Protection and Treatment for Inflammatory Bowel Disease

2019 ◽  
Vol 13 (7) ◽  
pp. 942-948 ◽  
Author(s):  
Savini Britto ◽  
Richard Kellermayer
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Common Element ◽  
Dietary Interventions ◽  
Paleolithic Diet ◽  
Exclusive Enteral Nutrition ◽  
Inflammatory Bowel ◽  
Total Fat ◽  
Dietary Treatments ◽  
To Receive

Abstract The nutritional developmental origins of inflammatory bowel disease[s] (IBDs: Crohn’s disease or Crohn disease [CD] and ulcerative colitis [UC]) and their diet-based treatments continue to receive increasing attention. There is growing evidence for the success of nutrition-based treatments, such as exclusive enteral nutrition [EEN] and the specific carbohydrate diet [SCD], in both paediatric and adult patients. Beyond these two dietary interventions, symptomatic benefit in IBD has also been shown from a gluten-free diet [GFD] and paleolithic diet [PALEO], among others. These nutritional therapies may point to critical factors in not only the pathology, but also the pathogenesis of the disease group. It is difficult, however, to discern a common element within the large number of diet-based causation theories [e.g. emulsifiers, processed foods, refrigeration, increased total fat intake, low fibre intake, carbohydrate dominant food, etc.] and the varied dietary treatments of IBD. This Viewpoint article highlights that carbohydrate variation links diet-based causation theories, and that carbohydrate monotony or persistence is the commonly shared characteristic of diet-based IBD therapy. Further research directed towards carbohydrate monotony may critically advance the prevention and treatment of these highly morbid conditions.

scholarly journals Role of Diet in Inflammatory Bowel Disease

2016 ◽  
Vol 68 (Suppl. 1) ◽  
pp. 32-41 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Intestinal Microbiome ◽  
Epithelial Barrier ◽  
Paleolithic Diet ◽  
Microbial Composition ◽  
Exclusive Enteral Nutrition ◽  
Intestinal Immune System ◽  
Inflammatory Bowel

The incidence of inflammatory bowel disease (IBD) is steadily in the rise in Western as well as in developing countries paralleling the increase of westernized diets, characterized by high protein and fat as well as excessive sugar intake, with less vegetables and fiber. An interesting hypothesis is that environmental (food-) triggered changes of the intestinal microbiome might cause a proinflammatory state preceding the development of IBD. Indeed, an intact intestinal epithelial barrier assuring a normal bacterial clearance of the intestinal surface is crucial to guarantee intestinal homeostasis. Any factors affecting the epithelial barrier function directly or indirectly may impact on this homeostasis, as well as any changes of the intestinal microbial composition. It is intriguing to learn that some frequently used food components impact on the quality of the intestinal barrier, as well as on the composition of the intestinal microbiome. This highlights the close interaction between living conditions, hygiene, food habits and food quality with the bacterial composition of the intestinal microbiome and the activation status of the intestinal immune system. There is clear evidence that nutritional therapy is highly successful in the treatment of Crohn's disease (CD). Exclusive enteral nutrition is well established as induction therapy of CD. New diets, such as a CD exclusion diet or defined diets (specific carbohydrate diets, FODMAP diet, Paleolithic diet) are being discussed as treatment options for IBD. Well-designed clinical trials in IBD are urgently required to define the precise role of each of these diets in the prevention or management of IBD. Up to now, the role of diet in IBD is highly undermined by lay and anecdotal reports without sufficient scientific proof.

Biosimilars of Adalimumab in Inflammatory Bowel Disease: Are we Ready for that?

2019 ◽  
Vol 25 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Marjorie Argollo ◽  
Gionata Fiorino ◽  
Daniela Gilardi ◽  
Federica Furfaro ◽  
Giulia Roda ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Care Providers ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Reference Product ◽  
European Medicines Agency ◽  
Care Providers ◽  
Inflammatory Bowel ◽  
To Receive ◽  
The Ideal

Introduction: Biosimilars present a considerable potential to reduce costs related to clinical management allowing health-care providers to reinvest this money, leading to a wider access to an effective biological treatment with monoclonal antibodies (mAb). Infliximab biosimilars have already been incorporated in daily clinical practice and are currently used in all indications for which the reference product (RP) was approved. Areas covered: In the next few years, also adalimumab biosimilars will become available for the treatment of inflammatory bowel disease (IBD). In fact, several of them (ABP501, BI 695501, GP2017, and SB5) have been approved by the European Medicines Agency (EMA) with the same indications of the reference product (Humira ®). Initial preclinical data proved a strong similarity between all biosimilars and the RP. Moreover, phase 3 studies in rheumatoid arthritis and psoriasis showed no differences in terms of efficacy, safety, and immunogenicity. Data on IBD patients are urgently needed. Expert opinion: Biosimilars of adalimumab showed equivalent clinical efficacy to the RP in other immunemediated diseases. However, defining the ideal patient’s profile to receive or to be switched to a biosimilar, choosing one biosimilar vs. another, or cross-switching among biosimilars, will become the next challenge in IBD.

scholarly journals COVID-19 Vaccine Hesitancy among Patients with Inflammatory Bowel Disease Receiving Biologic Therapies in Kuwait: A Cross-Sectional Study

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 55
Author(s):  
Mohammad Shehab ◽  
Yasmin Zurba ◽  
Ali Al Abdulsalam ◽  
Ahmad Alfadhli ◽  
Sara Elouali
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cross Sectional Study ◽  
Biologic Therapies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Patients ◽  
Inflammatory Bowel ◽  
To Receive

Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients receiving biologic therapies for IBD. Methods: A single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center in Kuwait. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from 1 June 2021 until 31 October 2021 were retrieved. Patients who received infliximab or vedolizumab at least six weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based on sex, age, type of biologic therapy and nationality. Results: The total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). Of the total, 112 (40.0%) patients were diagnosed with ulcerative colitis and 168 (60.0%) with Crohn’s disease. The number of ulcerative colitis patients who were vaccinated was 49 (43.8%) and the number of Crohn’s disease patients who were vaccinated was 68 (40.5%). The median age was 33.2 years and BMI was 24.8 kg/m2. With respect to the total number of patients, 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, patients above the age 50 were more likely to receive the vaccine than patients below the age of 50 (95.6% vs. 31.2% p < 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs. 25.0%, p < 0.001). There was no statistical difference between patients on infliximab and vedolizumab with regard to prevalence of vaccination (40.0% vs 48.0%, p = 0.34). Conclusion: The overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than that of the general population and world health organization (WHO) recom-mendation. Female patients, patients above the age of 50, and expatriates were more likely to receive the vaccine. Physicians should reinforce the safety and efficacy of COVID-19 vaccines among patients, especially IBD patients on biologic therapies, who express hesitancy towards them.

Current recommendations on the role of diet in the aetiology and management of IBD

2021 ◽  
pp. flgastro-2020-101429
Author(s):  
Konstantinos Gerasimidis ◽  
Lihi Godny ◽  
Rotem Sigall-Boneh ◽  
Vaios Svolos ◽  
Catherine Wall ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Onset ◽  
Well Being ◽  
Disease Development ◽  
Dietary Recommendations ◽  
Exclusive Enteral Nutrition ◽  
Established Disease ◽  
Inflammatory Bowel

Diet is a key modifier of risk of inflammatory bowel disease development and potentially a treatment option in patients with established disease. International organisations in gastroenterology and inflammatory bowel disease have published guidelines for the role of diet in disease onset and its management. Here, we discuss the major overarching themes arising from these guidelines and appraise recent literature on the role of diet for inflammatory bowel disease prevention, treatment of active disease and maintenance of remission, considering these themes. Except for exclusive enteral nutrition in active Crohn’s disease, we currently possess very little evidence to make any further dietary recommendations for the management of inflammatory bowel disease. There is also currently uncertainty on the extrapolation of epidemiological dietary signals on risk of disease development and preclinical experiments in animal models to management, once disease is established. Until high-quality evidence from clinical research becomes available, the only specific recommendations for inflammatory bowel disease we might safely give are those of healthy eating which apply for the general population for overall health and well-being.

scholarly journals Clinical Course and Dietary Patterns Among Patients Incorporating the Autoimmune Protocol for Management of Inflammatory Bowel Disease (P12-010-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Joy Lee ◽  
Christian Pedretti ◽  
Gauree Konijeti
Keyword(s):  
Inflammatory Bowel Disease ◽  
Support Groups ◽  
Dietary Patterns ◽  
Bowel Disease ◽  
Online Survey ◽  
Clinical Course ◽  
Immunosuppressive Agents ◽  
Food Group ◽  
Dietary Interventions ◽  
Inflammatory Bowel

Abstract Objectives The aim was to examine the clinical course and dietary patterns among patients incorporating autoimmune protocol (AIP) for management of inflammatory bowel disease (IBD). Methods An anonymous online survey was sent through electronic newsletters and support groups utilizing AIP. The survey assessed demographics, IBD disease activity, and medication use. Participants were asked about AIP utilization and food group reintroductions. Abdominal pain (AP), stool frequency (SF), and rectal bleeding (RB) were compared at baseline (BL, prior to starting AIP), week 6 (after starting AIP), and present, for both Crohn's disease (CD) and ulcerative colitis (UC). Results There were 78 respondents. Mean age was 39.4 years, with mean IBD duration 13.2 years. 78% had prior steroid exposure. 35% currently on immunosuppressive agents. 73% perceived achieving clinical remission due to AIP. This was more common among patients not on immunosuppression (76% vs. 24% on immunosuppression, P < 0.001). After starting AIP, 32% reported discontinuing steroids. AIP was initiated according to protocol by 73%, while 27% modified it. Food group reintroductions were started within 0–4 weeks of starting AIP among 8%, while 23% reintroduced within 5–8 weeks, 24% within 2–6 months, 23% within 6–12 months, and 13% after 12 months. Success of food group reintroductions varied (Table 1). Among patients with CD, improvement by ≥1 levels of symptoms by week 6 was reported by 77% for AP, 57% for SF, and 57% for RB. Compared to BL, reported symptoms improved by ≥1 levels in 70% for AP, 53% for SF, and 57% for RB. In contrast, disease worsening by ≥1 levels at week 6 was reported by 7% for AP and none for SF and RB. Among patients with UC, improvement by ≥1 levels by week 6 was reported by 72% for AP, 79% for SF, and 65% for RB. Compared to BL, reported symptoms improved by ≥1 levels in 65% for AP, 67% for SF, and 58% for RB. In contrast, disease worsening by ≥1 levels at week 6 was reported by 2% for AP, 2% for SF, and 5% for RB. Conclusions Patients utilizing AIP for management of IBD report clinical benefit of AIP, reduction of steroid use, and successful food group reintroduction. Dietary interventions could be another form of treatment in patients with IBD to improve symptoms and maintain remission. Funding Sources Not applicable. Supporting Tables, Images and/or Graphs

Sa2035 – Dietary Interventions Rapidly Alter Metabolomics Profile of Patients with Inflammatory Bowel Disease After Pouch Surgery

2019 ◽  
Vol 156 (6) ◽  
pp. S-480
Author(s):  
Lihi Godny ◽  
Leah Reshef ◽  
Tamar Pfeffer-Gik ◽  
Keren M. Rabinowitz ◽  
Idan Goren ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Dietary Interventions ◽  
Inflammatory Bowel ◽  
Pouch Surgery

P792 Breastfeeding in our patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
M Charro Calvillo ◽  
M Charro-Calvillo ◽  
E Peña-Gonzalez ◽  
Y Ber-Nieto ◽  
M T Botella Esteban ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Outbreaks ◽  
World Health Organisation ◽  
Public Hospitals ◽  
World Health ◽  
Great Opportunity ◽  
Inflammatory Bowel ◽  
Almost All ◽  
To Receive

Abstract Background Breastfeeding is one of the most important environmental factors in early childhood for later development of an Inflammatory Bowel Disease. The duration of lactation is essential for it to have a protective effect. In addition to IBD patients, breastfeeding can have a beneficial effect for preventing disease relapse. For these reasons, we plan to know how lactation develops in our group of patients with Inflammatory Bowel Disease (IBD). Methods A retrospective analysis of patients followed by gastroenterology consultations, with established diagnosis of IBD and with at least one gestation, in a period from January 2011 to January 2016. The data were collected a posteriori through two simple questionnaires, one completed by the patient, collecting the type of childbirth and breastfeeding she experienced and factors that influenced it. Another form is filled out by the gastroenterologist recording the characteristics of his inflammatory bowel disease. The data is collected in a structured database in Microsoft Excel and analysed with the SPSS statistic package for Windows. Results Data from 78 patients diagnosed with IBD are analysed from eight public hospitals in our autonomous community. 61.1% of patients have ulcerative colitis and 38.9% Crohn’s disease. The deliveries were mainly vaginal (82%), compared with 18% of caesarean-sections, four of them directly motivated by digestive disease. More than half of patients (57.7%) started breastfeeding after childbirth, 10.25% breastfeeding and 32.05% mixed breastfeeding But only 34.6% reach six months of breastfeeding, reaching 39.7% if we include mixed breastfeeding. In 17 patients (21.8%) their base-based inflammatory bowel disease directly influenced the development of lactation. Pharmacological treatment is the main cause for breastfeeding, followed by disease outbreaks, hospitalisations and surgery. Only 47.4% of the patients stated that in the IBD consultation they were given some information about breastfeeding, although almost all replied that they would have liked to receive it. Conclusion The majority of patients with inflammatory bowel disease in our consultations, do not reach six months of breastfeeding currently recommended by the World Health Organisation, so we have a great opportunity for improvement in this field and as gastroenterologists, we can contribute by providing more information to our patients about breastfeeding and its relationship with IBD.

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