Because inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) is a disease of the digestive system, patients have many concerns about diet and nutrition. You may find it surprising that there is no evidence to date that dietary factors play a role in the development and progression of inflammatory bowel disease, but once you are already sick, it is possible that paying attention to diet and making appropriate dietary adjustments will reduce symptoms and promote recovery. As clinical research progresses, we will learn more about the relationship between nutrition and inflammatory bowel disease. Is nutrition particularly important for people with inflammatory bowel disease? Of course, it is very important! Patients with inflammatory bowel disease, especially those with Crohn’s, are prone to malnutrition. The main reasons for this are as follows: firstly, the patient’s appetite decreases; secondly, the chronic state of the disease increases the demand for calories, especially when inflammatory bowel disease breaks out; finally, the digestion and absorption of proteins, fats, carbohydrates, water, vitamins and minerals decreases in patients with inflammatory bowel disease (especially Crohn’s disease), so that most of the nutrients in food are not taken in by the body. On the other hand, a good nutritional status facilitates the body’s self-recovery. Therefore, any malnutrition needs to be corrected. Restoring and maintaining a good nutritional status is an important aspect of the treatment of inflammatory bowel disease. What kind of diet should be consumed when the disease is active? An appropriate diet should include all nutrients. The main sources of protein are meat, fish, poultry and, if tolerated, dairy products. The main sources of carbohydrates are bread, cereals, starches, fruits and vegetables. The main sources of fat are vegetable oils and animal oils. Your supervising physician will help you establish an appropriate diet. In general, if the colon is involved by inflammation (common in ulcerative colitis), then high-fiber foods such as nuts, corn, and vegetables should be avoided. Is there any one food that exacerbates the inflammation of the intestine in inflammatory bowel disease? There is no such food. There is no evidence that any one hygienic food exacerbates intestinal inflammation, although a particular food may exacerbate it for a particular patient. However, any contaminated food that causes food poisoning or dysentery will exacerbate inflammatory bowel disease. Can the intestines of people with inflammatory bowel disease absorb food normally? In most cases, yes. If the inflammation involves only the large intestine, absorption is usually not impaired. However, patients with Crohn’s disease often have digestive and absorptive insufficiency, as Crohn’s disease mostly involves the small intestine. The degree of absorption insufficiency is related to the severity of the inflammation in the small intestine and the length of the small intestine that has been removed. If only one to two feet of the distal ileum is affected by inflammation, absorption of nutrients is generally unaffected, except for vitamin B12, which is impaired. If two to three feet of the ileum is involved by inflammation, fat absorption will receive a serious impact. If the upper portion of the small intestine is involved by inflammation, the absorption of many nutrients, including proteins, fats, carbohydrates, minerals, and vitamins, will be impaired. Some drugs used to treat inflammatory bowel disease, especially 5-aminosalicylates, will affect the absorption of folic acid (a vitamin). Folic acid, which has an important role in the fight against cancer and in reducing fetal malformations, must be supplemented for patients using such drugs. Does the patient need additional mineral supplementation? Most patients with inflammatory bowel disease do not require mineral supplementation. However, in patients with extensive involvement of the small intestine or in patients whose important bowel segments have been surgically removed, supplementation with calcium, phosphorus and magnesium is necessary. In addition, iron therapy helps to correct iron deficiency anemia. However, oral iron can darken the stool and sometimes cause false positive fecal occult blood. Do patients need to be concerned about fruit intake? Of course they do. Patients with chronic diarrhea are prone to dehydration of the organism. If the fruit is not supplemented in time, the kidney function will be affected. Patients with Crohn’s or other diarrhea are prone to develop kidney stones. In addition, the loss of water and salts can make a person feel weak. For both of these reasons, patients with inflammatory bowel disease need to consume adequate fluids, especially on hot days, when the body loses more salt and water through the skin. Does nutrition affect growth? Growth will be affected in patients who develop the disease before puberty. Inadequate nutritional intake of food will aggravate the growth retardation. Therefore, a good diet and adequate caloric intake are very important. In addition, control of the disease, either by medication or by surgical removal of the severely diseased segment of the intestine, is necessary for growth and development. What is nutritional support? Enteral nutrition is necessary because nutritional support can facilitate recovery in patients with inflammatory bowel disease. Enteral nutrition is usually administered by placing a tube from the nasal cavity to the stomach cavity and injecting a configured nutrient solution, usually at night. The advantage of enteral nutrition at night is that the patient can sleep during the night while receiving enteral nutrition; early the next morning, the patient can remove the gastric tube and carry out their normal daily activities. In this way, the patient can get enough nutrients needed, and then can have three meals a day as normal during the day without worrying about nutritional deficiencies. Enteral nutrition can also be administered by means of a gastrostomy. A gastrostomy is a tube that is inserted through the anterior wall of the abdomen directly into the stomach cavity, thus allowing the cavity to be directly connected to the outside world. This type of nutrition is also usually administered at night, but can also be done intermittently throughout the day. Parenteral nutrition (where the catheter is connected to a large vein and the nutrient solution is dripped from the catheter) is rarely used due to its inconvenience. In addition, parenteral nutrition has many complications, and at the same time leaves the gastrointestinal mucosa undernourished, resulting in gastrointestinal insufficiency.