医学
炎症性肠病
溃疡性结肠炎
医学营养疗法
饮食管理
营养不良
肠外营养
疾病
克罗恩病
炎症性肠病
重症监护医学
饮食疗法
多学科方法
内科学
社会科学
社会学
作者
Jessica A. Fitzpatrick,Sarah L. Melton,Chu K Yao,Peter R. Gibson,Emma P. Halmos
标识
DOI:10.1038/s41575-022-00619-5
摘要
Historically, dietitians played a minor part in the management of inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. Patients were commonly referred for consequences of uncontrolled disease, such as malnutrition and bowel obstruction risk. Today, dietitians are fundamental members of the multidisciplinary IBD team, from educating on the role of diet at diagnosis and throughout the lifespan of a patient with IBD to guiding primary induction therapy. This aspect is reflected in published guidelines for IBD management, which previously placed diet as only a minor factor, but now have diet-specific publications. This Review describes a four-step approach in a dietitian’s assessment and management of diet in patients with IBD: (1) identifying and correcting nutritional gaps and dietary imbalances; (2) considering diet to treat active disease with the use of exclusive enteral nutrition (EEN) or emerging diets that could replace EEN; (3) using therapeutic diets to control existing complications of IBD, such as reduced fibre to prevent bowel obstruction in stricturing disease or a fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet to manage co-existing functional gut symptoms; and (4) considering the role of diet in preventing IBD development in high-risk populations.
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