ESPEN guideline: Clinical nutrition in inflammatory bowel disease

Scientific paper - Review paper

• Title (spanish): Guía ESPEN: Nutrición clínica en la enfermedad inflamatoria intestinal
• Author: Stephan C. Bischoff
• Author: Johanna Escher
• Author: Xavier Hébuterne
• Author: Stanisław Kłęk
• Author: Željko Krznarić; MBZ: 75865
• Author: Stéphane Schneider
• Author: Raanan Shamir
• Author: Kalina Stardelova
• Author: Nicolette Wierdsma
• Author: Anthony E Wiskin
• Author: Alastair Forbes
• Author: Miguel Montoro
• Author: Rosa Burgos Peláez
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Introduction: the ESPEN guideline offers a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). ----- Methodology: the guideline is based on a extensive systematic review of the literature, but relies on expert opinion when objective data are lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process, in which uniformly positive responses (agree or strongly agree) were required. ----- Results: IBD is increasingly common and potential dietary factors in its etiology are briefly reviewed. Malnutrition is highly prevalent in IBD - especially in Crohn's disease. Increased energy and protein requirements are observed in some patients. The management of malnutrition in IBD is considered within the general context of support for malnourished patients. Treatment of iron deficiency (parenterally, if necessary) is strongly recommended. Routine provision of a special diet in IBD is not, however, supported. Parenteral nutrition is indicated only when enteral nutrition has failed or is impossible. The recommended perioperative management of patients with IBD undergoing surgery accords with general ESPEN guidance for patients having abdominal surgery. Probiotics may be helpful in UC but not in Crohn's disease. Primary therapy using nutrition to treat IBD is not supported in ulcerative colitis but is moderately well supported in Crohn's disease, especially in children, where the adverse consequences of steroid therapy are proportionally greater. However, exclusion diets are generally not recommended and there is little evidence to support any particular formula feed when nutritional regimens are constructed.
----- Conclusions: available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 64 recommendations, of which 9 are very strong recommendations (grade A), 22 are strong recommendations (grade B), and 12 are based only on sparse evidence (grade 0); 21 recommendations are good practice points (GPP).

• Keywords (english): Child; Colitis, Ulcerative / complications; Colitis, Ulcerative / therapy; Crohn Disease / complications; Crohn Disease / therapy; Enteral Nutrition / adverse effects; Humans; Inflammatory Bowel Diseases / complications; Inflammatory Bowel Diseases / therapy; Malnutrition / complications; Malnutrition / therapy
• Language: spanish
• Publication type: Scientific paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Nutrición Hospitalaria
• Numbering: vol. 39, no. 3, pp. 678-703
• p-ISSN: 0212-1611
• e-ISSN: 1699-5198
• DOI: https://doi.org/10.20960/nh.03857
• URN:NBN: urn:nbn:hr:105:666568
• Publication: 2022-06-24
• Document URL: https://www.nutricionhospitalaria.org/articles/03857/show
• Type of resource: Text
• Access conditions: Open access
• Created on: 2022-11-15 10:09:24