4.4 Article Proceedings Paper

Diet and gut microbiota manipulation for the management of Crohn's disease and ulcerative colitis

Journal

PROCEEDINGS OF THE NUTRITION SOCIETY
Volume 80, Issue 4, Pages 409-423

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0029665121002846

Keywords

Enteral nutrition; Inflammatory bowel disease; Crohn's disease; Ulcerative colitis; Gut microbiota; Short-chain fatty acids; Metabolomics; Microbiome

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The etiology of IBD involves multiple factors, with diet and gut microbiota playing crucial roles in disease management. Clinical trials focusing on the effects of EEN on gut microbiota in children with CD offer insights into disease pathogenesis, while evidence linking food-based dietary therapies for IBD with gut microbiota mechanisms remains inconclusive.
The aetiology of inflammatory bowel disease (IBD) is multifactorial, with diet and gut microbiota playing an important role. Nonetheless, there are very few studies, particularly clinical research, which have explored the interaction between diet and gut microbiota. In the current review, we summarise the evidence from clinical trials exploring the interactions between the gut microbiota and diet in the management of IBD. Data from the effect of exclusive enteral nutrition (EEN) on the gut microbiota of children with active Crohn's disease (CD), receiving induction treatment, offer opportunities to understand the role of gut microbiota in underlying disease pathogenesis and develop novel dietary and pharmacological microbial therapeutics. In contrast, the evidence which links the effectiveness of food-based dietary therapies for IBD with mechanisms involving the gut microbiota is far less convincing. The microbial signals arising from these dietary therapies are inconsistent and vary compared to the effects of effective treatment with EEN in CD.

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