title: British Dietetic Association evidence-based guidelines for the dietary management of Crohn's disease in adults.
abstract: BACKGROUND
  Crohn's disease is a debilitating chronic inflammatory bowel disease. Appropriate use of diet and nutritional therapy is integral to the overall management strategy of Crohn's disease. The aim was to develop evidence-based guidelines on the dietary management of Crohn's disease in adults.
  
  
  METHODS
  Questions relating to the dietary management of Crohn's disease were developed. These included the roles of enteral nutrition to induce remission, food re-introduction diets to structure food re-introduction and maintain remission, and dietary management of stricturing disease, as well as whether probiotics or prebiotics induce or maintain remission. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines CINAHL, Cochrane Library, EMBASE, MEDLINE, Scopus and Web of Science. Evidence statements, recommendations, practical considerations and research recommendations were developed.
  
  
  RESULTS
  Fifteen research papers were critically appraised and the evidence formed the basis of these guidelines. Although corticosteroids appear to be more effective, enteral nutrition (elemental or non-elemental) can be offered as an alternative option to induce disease remission. After a course of enteral nutrition, food re-introduction diets may be useful to structure food re-introduction and help maintain disease remission. Dietary fibre is contraindicated in the presence of strictures as a result of the risk of mechanical obstruction. The use of probiotics and prebiotics is not currently supported.
  
  
  CONCLUSIONS
  As an alternative to corticosteroids, evidence supports enteral nutrition to induce disease remission. Food re-introduction diets provide structure to food re-introduction and help maintain disease remission. These guidelines aim to reduce variation in clinical practice.
authors: Department of Nutrition and Dietetics, Addenbrookes, Cambridge, UK.
authors: J
authors: J
authors: Lee
authors: R
authors: R
authors: Allen
authors: S
authors: S
authors: Ashley
authors: S
authors: S
authors: Becker
authors: P
authors: P
authors: Cummins
authors: A
authors: A
authors: Gbadamosi
authors: O
authors: O
authors: Gooding
authors: J
authors: J
authors: Huston
authors: J
authors: J
authors: Le Couteur
authors: D
authors: D
authors: O'Sullivan
authors: S
authors: S
authors: Wilson
authors: M C E
authors: MC
authors: Lomer
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003424:Crohn Disease / Q000178:diet therapy*; D004043:Dietary Fiber / Q000008:administration & dosage; D004046:Dietetics; D004750:Enteral Nutrition; D019317:Evidence-Based Medicine; D006801:Humans; D016239:MEDLINE; D044623:Nutrition Therapy; D010380:Peer Review; D056692:Prebiotics; D019936:Probiotics; D012074:Remission Induction; D006113:United Kingdom
chemical_list: D000305:Adrenal Cortex Hormones; D004043:Dietary Fiber; D056692:Prebiotics
keywords: Crohn's disease; diet; dietary fibre; enteral nutrition; exclusion diet; food re-introduction diets; prebiotics; probiotics; strictures