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P480. Importance of diet in inflammatory bowel disease – data from the patients' view

T. Molnár1, K. Farkas1, F. Nagy1, M. Szücs2, A. Bálint1, Z. Szepes1, T. Wittmann1, 1University of Szeged, First Department of Medicine, Szeged, Hungary, 2University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary

Background

Inflammatory bowel diseases (IBD – Crohn's disease [CD] and ulcerative colitis [UC]) are chronic, relapsing conditions caused by several genetic, immunologic and environmental factors. Although lifestyle and western diet are supposed to be associated with the rising incidence of IBD, the role of diet is controversial in the daily management of the patients. Doctors tend to depreciate the importance of these environmental factors while most of the patients long to hear strict guidelines. The aim of this study was to assess our patients' opinion about the importance of diet and to evaluate the role of special meals and ingredients in the relapse of IBD using a new, structured questionnaire.

Methods

One hundred and fifty-four patients treated at our tertiary IBD center participated in this nutritional survey. Most of the patients were female (106 vs. 48), mean disease duration was 11.8 years (1–44 years) and the two types of IBD was represented almost equally (CD 54.7%, UC 45.3%). Average body mass index was 24.0 (14.8–39.3). Lactose intolerance and IBD coexisted in 14.3%, while celiac disease and IBD in 3.2% of patients.

Results

42.3% of CD patients vs. 19.4% of UC patients voted that nutrition has an important role in the development of IBD (p = 0.003). 39.6% of our patients are on diet permanently, while 44.3% only at the time of flares and 16.1% has never been on. 52.7% of IBD patients thought that diet can prevent relapse-significantly more patients with CD than with UC (61.7 vs. 43.3%, p = 0.03). 68.6% of the IBD patients felt that diet is as important as drug therapy. 91% of CD and 79% of UC patients (p = 0.033) reported ingredients or meals which worsen the disease activity. The worst five ingredients on disease activity were red pepper, pepper, curry, onion and cream. The top of ‘harmful foods’ list was milk, cabbage and spicy foods. The most favorite foods indicated by the patients are rice, chicken, fish, banana and potato. Half of the patients never drink milk, 39% because of diarrhea, whereas 11% does not like it. Half of the milk consumer patients can drink milk only in remission.

Conclusion

On the basis of our survey, diet is more important in the pathogenesis and management of CD than UC. Most of the patients think that diet can prevent relapse and more than two-third of the patients find nutrition o be as important as drug therapy. According to our patients' view, we should take more care on the nutritional factors during the management of IBD in the future.