title: The role of dietary supplements in inflammatory bowel disease: a systematic review.
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.
authors: aGastroenterology 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.
authors: Roberta E
authors: RE
authors: Rossi
authors: Tara
authors: T
authors: Whyand
authors: Charles D
authors: CD
authors: Murray
authors: Mark I
authors: MI
authors: Hamilton
authors: Dario
authors: D
authors: Conte
authors: Martyn E
authors: ME
authors: Caplin
mesh_terms: D035685:Andrographis; D029743:Boswellia; D003474:Curcumin / Q000627:therapeutic use; D019587:Dietary Supplements; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007082:Ileum / Q000601:surgery; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D007501:Iron / Q000627:therapeutic use; D044342:Malnutrition / Q000150:complications / Q000188:drug therapy*; D028321:Plant Preparations / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D013662:Tea; D014131:Trace Elements / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy / Q000209:etiology; D014803:Vitamin B Complex / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy; D014815:Vitamins / Q000627:therapeutic use; D015032:Zinc / Q000627:therapeutic use
chemical_list: D028321:Plant Preparations; D013662:Tea; D014131:Trace Elements; D014815:Vitamins; D014803:Vitamin B Complex; D014807:Vitamin D; D005492:Folic Acid; D007501:Iron; D003474:Curcumin; D015032:Zinc