ESPEN Guideline: Clinical Nutrition in inflammatory bowel disease

Forbes, Alastair, Escher, Johanna, Hébuterne, Xavier, Kłęk, Stanisław, Krznaric, Zeljko, Schneider, Stéphane, Shamir, Raanan, Stardelova, Kalina, Wierdsma, Nicolette, Wiskin, Anthony E and Bischoff, Stephan C (2017) ESPEN Guideline: Clinical Nutrition in inflammatory bowel disease. Clinical Nutrition, 36 (2). 321–347. ISSN 0261-5614

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Abstract

Introduction: The ESPEN guideline presents a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). Methodology: The guideline is based on extensive systematic review of the literature, but relies on expert opinion when objective data were lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required. Results: IBD is increasingly common and potential dietary factors in its aetiology are briefly reviewed. Malnutrition is highly prevalent in IBD – especially in Crohn's disease. Increased energy and protein requirements are observed in some patients. The management of malnu-trition in IBD is considered within the general context of support for malnourished patients. Treatment of iron deficiency (parenterally if necessary) is strongly recommended. Routine provision of a special diet in IBD is not however supported. Parenteral nutrition is indicated only when enteral nutrition has failed or is impossible. The recommended perioperative man-agement of patients with IBD undergoing surgery accords with general ESPEN guidance for patients having abdominal surgery. Probiotics may be helpful in UC but not Crohn's disease. Primary therapy using nutrition to treat IBD is not supported in ulcerative colitis, but is mod-erately well supported in Crohn's disease, especially in children where the adverse conse-quences of steroid therapy are proportionally greater. However, exclusion diets are generally not recommended and there is little evidence to support any particular formula feed when nutritional regimens are constructed. Conclusions: Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 64 recommendations, of which 9 are very strong recom-mendations (grade A), 22 are strong recommendations (grade B) and 12 are based only on sparse evidence (grade 0); 21 recommendations are good practice points (GPP).

Item Type: Article
Additional Information: There is a correction see: https://doi.org/10.1016/j.clnu.2019.03.004
Uncontrolled Keywords: crohn’s disease,ulcerative colitis,enteral nutrition,parenteral nutrition,inflammatory bowel disease,nutritional therapy
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: Pure Connector
Date Deposited: 05 Jan 2017 00:02
Last Modified: 15 Sep 2020 23:44
URI: https://ueaeprints.uea.ac.uk/id/eprint/61910
DOI: 10.1016/j.clnu.2016.12.027

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