Update on Diet and Nutritional Therapies in Patients with Inflammatory Bowel Disease

While the exact cause of inflammatory bowel disease (IBD) remains unclear, interactions among several complex mechanisms are thought to contribute to its pathogenesis. One such factor is diet, which has recently been investigated for its role in both IBD pathogenesis and treatment. This review examines the evidence regarding diet, nutrition support, and dietary supplements for managing IBD. The diets discussed include low fiber/residue, Crohn's Disease exclusion, Specific Carbohydrate, Mediterranean, Anti-Inflammatory, Autoimmune Protocol, low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), lactose-free, and gluten-free diets. Nutrition support options include enteral nutrition, partial enteral nutrition, and parenteral nutrition. These modalities can be considered in specific situations, such as perioperative nutrition, protein-calorie malnutrition, and induction of remission. Dietary supplements studied for managing IBD include prebiotics, probiotics, vitamin D, omega-3 fatty acids, polyphenols, and aloe vera, which may be beneficial in managing IBD. Some challenges to consider in the dietary management of IBD include food avoidance, food insecurity, and cultural practices. When contemplating initiating one of these options, input from a multidisciplinary gastroenterology team should be considered.