Diet Advice for Crohn's Disease: FODMAP and Beyond.

Stefan L Popa,Cristina Pop,Dan L Dumitrascu

doi:10.3390/nu12123751

Stefan L Popa, Cristina Pop + Show 1 more

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https://doi.org/10.3390/nu12123751

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Abstract

Crohn’s disease (CD) is a chronic, progressive, and destructive granulomatous inflammatory bowel disorder that can involve any part of the gastrointestinal tract. It has been presumed that different types of diet might improve gastrointestinal symptoms in CD patients. The aim of this review was to clarify the efficiency and indications of a low-“fermentable oligo-, di-, mono-saccharides and polyols” (FODMAP) diet (LFD) in CD and to further analyze the available data on other types of diets. PubMed, Cochrane Library, EMBASE and WILEY databases were screened for relevant publications regarding the effect of FODMAP diets on CD. Our search identified 12 articles analyzing the effect of an LFD in CD, 5 articles analyzing the effect of a Mediterranean diet (MD), 2 articles analyzing the effect of a vegetarian diet (VD), and 2 articles analyzing the effect of a low-lactose diet (LLD). The majority of the studies included in this review show the significant efficiency of the LFD in CD patients. We found significant evidence demonstrating that the LFD has a favorable impact on gastrointestinal symptoms in CD patients. Notwithstanding the evidence, it remains to be established if an LFD is more efficient than other types of diets in the short term and especially in the long term.

Highlights

Crohn’s disease (CD) is a chronic, progressive, and destructive granulomatous inflammatory bowel disorder that can involve any part of the gastrointestinal tract from mouth to anus, predominantly the terminal ileum, ileocaecal region, colon, and perianal region [1,2,3]
In order to verify the anti-inflammatory effect of an LFD, Zhou, hypothesized that a high-FODMAP diet (HFM) increases the intestinal inflammatory activity, barrier et al hypothesized that a high-FODMAP diet (HFM) increases the intestinal inflammatory activity, dysfunctions, and visceral hypersensitivity [24]
The results showed that abdominal pain, bloating and flatulence improved in CD patients and the number of diarrheic stools decreased, but the LFD had no effect on constipation [34]

Summary

Introduction

Crohn’s disease (CD) is a chronic, progressive, and destructive granulomatous inflammatory bowel disorder that can involve any part of the gastrointestinal tract from mouth to anus, predominantly the terminal ileum, ileocaecal region, colon, and perianal region [1,2,3]. World Health Organization diagnostic criteria for CD include: discontinuous or segmental lesions, as well as a cobblestone appearance or longitudinal ulcer, noted on radiologic studies, endoscopy, and resected specimens; transmural inflammation, as evidenced by clinical evaluation, radiologic studies, biopsy findings, and resected specimens; noncaseating granulomas, as revealed on biopsy samples and resected specimens; fissures and fistulas, as evidenced by clinical evaluation, radiologic studies, and resected specimens; perianal disorders upon clinical evaluation [4,5,6,7,8]. For 15% of patients initially diagnosed with CD, the diagnosis changes to ulcerative colitis (UC) during the first year [5,6,7]

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