High resolution computed tomography detection of alimentary factors related to arthropathies in inflammatory bowel diseases

Abstract

Alimentary factors of enterogen arthropathies were studied, in particular the early morphological detection, to prevent the disease progression by nutritional prescriptions. Authors compared the method of high resolution computed tomography (HRCT) with conventional X-ray and nuclear medicine investigations. The results showed the superiority of HRCT to detect cartilage erosions and ligamental calcifications in the sacroiliac joint and lumbar facet joint. The importance of nutritional factors is briefly discussed. The need for high quality and high quantity food of patients suffering from inflammatory bowel diseases (IBD) is well known. Elemental diet is effective for remission of IBD. Folic acid intake is extremely important. Total parenteral nutrition in acute active disease (Crohn's fistulas) has not been proved to effect IBD. Elimination of whole protein as a possible luminal factor for long term application can help, if elementary amino acids are in the diet. Eicosapentaenoic acid and docosahexaenoic acid (major components of fish oils) have beneficial effects. Polyunsaturated fatty acids in the diet can decrease the inflammation. Antioxidants, glutamine are essential in the diet. Removal of fat is effective to get remission. Alimentary complication in IBD patients can be osteoporosis, so there is a need for regular bone densitometry. Conclusion of the study suggests that HRCT offers more sensitive detection of enterogen arthropathy related changes. The predictive value of this diagnostic method is accurate enough to advise restrictive and/or supplemental diets of IBD patients. Dietary therapy allows circumvention of the adverse side-effects of repeated courses of steroids.