The role of dietary supplements in inflammatory bowel disease: a systematic review
The role of dietary supplements in inflammatory bowel disease: a systematic review.
- 1aGastroenterology
and Endoscopy Unit-Fondazione IRCCS Cà Granda Ospedale Maggiore
Policlinico, Department of Pathophysiology and Transplantation,
Università degli Studi di Milano, Milan, ItalybDepartment of Nutrition
& Dietetics, Centre of GastroenterologycCentre for Gastroenterology,
Royal Free Hospital, London, UK.
Abstract
Inflammatory
bowel diseases (IBD) are chronic immune disorders of unclear aetiology.
Dietary deficiencies may be a potential pathogenic factor in their
development. Patients often take food supplements without knowledge of
any evidence base. We have therefore assessed the evidence for food
supplementation in the management of IBD. A PubMed search was performed
for the terms Inflammatory bowel disease; nutritional deficiencies;
dietary supplements; curcumin; green tea; vitamin D/other vitamins;
folic acid; iron; zinc; probiotics; andrographis paniculata; and
boswellia serrate. PubMed was used to search for all relevant articles
published between January 1975 and September 2015. Curcumin
supplementation has been reported to be effective in reducing the
symptoms and the inflammatory indices in IBD patients. Similar results
have been observed for green tea; however, pertinent studies are
limited. Vitamin D supplementation may help to increase bone mineral
density in IBD patients and to reduce disease activity. IBD patients
with ileal resections higher than 20 cm may develop vitamin B12
deficiency that requires parenteral supplementation. There is no current
evidence to support fat-soluble vitamin supplementation in IBD
patients. Zinc and iron should be supplemented in selected cases.
Probiotics (VSL#3) may reduce disease activity in IBD patients with
pouchitis. Complementary and alternative
medicines are used by IBD patients and some studies have shown
promising results. In summary, attention to dietary factors such as
curcumin, green tea and vitamins, including vitamins D and B12, appears
to be beneficial and, if necessary, supplementation may be appropriate.
