title: Nutrition and inflammatory bowel disease: primary or adjuvant therapy.
abstract: OBJECTIVE
  Our understanding of the importance of nutrition in inflammatory bowel disease (IBD) continues to improve. With increasing evidence or cumulative evidence, this article reviews the current data for the role of nutrition in IBD pathogenesis, disease exacerbation and its use in the treatment of IBD in a clinically relevant context.
  
  
  RESULTS
  Irritable bowel syndrome and obesity prevalence is rising, and is increasingly being recognized in patients with IBD. Exclusive enteral nutrition remains highly relevant because of its efficacy and superior side-effect profile, even when considered against new pharmacological treatments, but requires patient motivation. We are now beginning to understand the importance of micronutrients such as iron and vitamin D, which may not only alter the bowel flora but also have an immune-modulatory effect. More recently, a prebiotic and probiotic combination has been used in a randomized trial for the treatment of IBD.
  
  
  CONCLUSIONS
  Macronutrient and micronutrient assessment should be an essential part of nutritional assessment of all patients with IBD. Although research is needed to further our understanding of the immune-modulatory effects of nutrients and supplements, better and more effective therapies combining nutrition and drug treatments like immune-suppressants should be explored.
authors.affiliation: Department of Paediatrics, Poole Hospital NHS Trust, Poole, UK.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Tighe
authors.forename: J R Fraser
authors.initials: JR
authors.lastname: Cummings
authors.forename: Nadeem A
authors.initials: NA
authors.lastname: Afzal
mesh_terms: D004032:Diet; D004750:Enteral Nutrition; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000209:etiology / Q000628:therapy*; D007422:Intestines / Q000382:microbiology; D043183:Irritable Bowel Syndrome; D018977:Micronutrients / Q000627:therapeutic use*; D044623:Nutrition Therapy; D009765:Obesity; D056692:Prebiotics; D019936:Probiotics / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D018977:Micronutrients; D056692:Prebiotics