Inflammatory bowel diseases: principles of nutritional therapy
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
;
57(4): 187-198, July-Aug. 2002. ilus, tab
Artigo
em Inglês
| LILACS
| ID: lil-317587
RESUMO
Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory response, thus influencing disease activity. Total parenteral nutrition has been used to correct and to prevent nutritional disturbances and to promote bowel rest during active disease, mainly in cases of digestive fistulae with high output. Its use should be reserved for patients who cannot tolerate enteral nutrition. Enteral nutrition is effective in inducing clinical remission in adults and promoting growth in children. Due to its low complication rate and lower costs, enteral nutrition should be preferred over total parenteral nutrition whenever possible. Both present equal effectiveness in primary therapy for remission of active Crohn's disease. Nutritional intervention may improve outcome in certain individuals; however, because of the costs and complications of such therapy, careful selection is warranted, especially in patients presumed to need total parenteral nutrition. Recent research has focused on the use of nutrients as primary treatment agents. Immunonutrition is an important therapeutic alternative in the management of inflammatory bowel diseases, modulating the inflammation and changing the eicosanoid synthesis profile. However, beneficial reported effects have yet to be translated into the clinical practice. The real efficacy of these and other nutrients (glutamine, short-chain fatty acids, antioxidants) still need further evaluation through prospective and randomized trials
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Doenças Inflamatórias Intestinais
/
Apoio Nutricional
/
Distúrbios Nutricionais
Tipo de estudo:
Ensaio Clínico Controlado
Limite:
Humanos
Idioma:
Inglês
Revista:
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
Assunto da revista:
Medicina
Ano de publicação:
2002
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
University of Säo Paulo/BR
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