Diet therapy can reduce the need for drugs and surgery in Crohn's disease and ulcerative colitis, the two most common forms of inflammatory bowel disease (IBD). A recent article in the World Journal of Enterology reports current strategies include elimination of selected foods, increases in consumption of key nutrients, and for severe cases, elemental diets or total parenteral nutrition (intravenous feeding).
Food intolerance is highly individual. The reference article reports that IBD patients have been found to be sensitive to any one or more of the following: wheat, milk, yeast, egg, potato, rye, tea, coffee, apples, mushrooms, oats, chocolate, onions, cabbage, apples, strawberries, citrus fruits, beef, or peanuts. An efficient way to check for food intolerance is to start with an elemental diet, which provides just the basic nutrients. Then one food per day is added. Any food that causes pain or diarrhea is then eliminated from the diet. In a study of personalized exclusion diets, 62 percent of the patients were still in remission at two years with no other medical treatment. An impressive 45 percent maintained remission for five years with diet alone.
Elemental diets can sometimes produce remission, but they are undesirable for the long term because they are not palatable. Total parental nutrition is a more drastic approach, in which all nutrition is delivered intravenously (no food by mouth). This allows bowel rest from antigenic stimuli. It can be very effective in the short term, but it is invasive and expensive, and has adverse side effects.
Beneficial foods include omega-3 fatty acids and fiber. The omega-3 fatty acids, from fish oil or plant sources, is believed to have general anti-inflammatory effects. Dietary fiber is the source of short-chain fatty acids, which are produced by anaerobic bacterial fermentation of fiber. IBD has been linked to impaired production of short chain fatty acids.
The role of sugar has been investigated in several trials. Most of them looked at a high fiber, low sugar diet, and found benefits. However, the only trial to study low sugar effects alone showed no statistically significant benefit.