Abstract
Enteral diets have been shown to be as effective as steroids in inducing remission of active Crohn's disease. Elemental, semi-elemental and polymeric diets produce similar results. The short periods of time over which such diets have been used have not affected the subsequent progress of the disease. The mechanism of action of enteral diets remains speculative but bowel rest together with an improvement in immunological function and nutritional status are considered to be important. Immunomodulation through the use of specific nutrients (glutamine, arginine, nucleotides, PUFA from the α6 series) could affect the inflammatory response and its recurrence but clinical trials are lacking. Parenteral nutrition and fibre free enteral nutrition is not effective in treating ulcerative colitis possibly because the colon is deprived of short chain fatty acids (formed from fermentation of fibre), which are an important fuel for the colonocyte.
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