P632. Dietary practices in patients with inflammatory bowel disease - food for thought
An epidemiological association implicating diet in Inflammatory Bowel Disease (IBD) risk or protection is widely accepted. Despite unprecedented advances in aetio-pathogenesis, nutritional research has been limited by heterogeneity of study design, variability of diet, and difficulty in obtaining accurate longitudinal dietary data. Patients with IBD often make links to diet in clinical consultations, but there is a dearth of literature exploring dietary perceptions and practices in an IBD population .
The aim of the study was to evaluate dietary beliefs and behaviours in patients with IBD.
We developed a 25-item questionnaire assessing demographics, dietary beliefs and habits, impact on social life and patients' use of resources for dietary advice. The questionnaire was prospectively administered to consecutive IBD patients attending our IBD clinics from September to November 2013.
A total of 187 patients participated in the study. The average age was 48 years; 55% were female and 85% Caucasian. The median disease duration was 6 years. Thirty-nine percent had Crohn's Disease and 52% had Ulcerative Colitis. Of the respondents, 49% felt that diet could be the initiating factor in IBD and 58% felt it could trigger a flare. Fifty-nine percent reported a modification in their diet and 38% reported taking dietary supplements. Worsening of symptoms with certain food and drinks was reported by 62%, the commonest being spicy food (46%), fatty food (33%) and alcohol (22%). A minority (17%) reported improvement in symptoms with certain foods and 66% deprived themselves of certain foods to prevent relapse with 24% refusing to dine outside of home for fear of causing relapse. Seventy-four percent of respondents believed that IBD affects appetite. On a visual analogue scale of 1–10, mean scores for appetite in disease remission and during disease relapse were 8 (SD 2.0) and 4 (SD 2.9) respectively (p = 0.001). Nearly half of respondents (47%) had never received any formal dietary advice, and most (67%) requested further dietary advice from dieticians (43%), nurses (34%) and patient information leaflets (28%).
Patients express a belief that diet affects IBD symptoms and disease activity, with a high level of consistency around key perceived triggers. Whether all the symptoms reported are due to active inflammation cannot be ascertained, but the potential exists for dietary components triggering active disease and perpetuating gut injury, impacting on quality of life and health care costs. This should serve as an impetus for further patient centered research.
1. Zallot C et al. Dietary beliefs and behavior among inflammatory bowel disease patients. Inflamm Bowel Dis. 2013 Jan; 19(1): 66–72.