Impact of environmental and dietary factors on the course of inflammatory bowel disease
Impact of environmental and dietary factors on the course of inflammatory bowel disease
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DOI：
10.3748/wjg.v18.i29.3814
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发表时间：
2012-08-07
影响因子：
4.3
通讯作者：
Domenech, Eugeni
中科院分区：
文献类型：
--
作者：
Cabre, Eduard;Domenech, Eugeni
一些环境因素除了在炎症性肠病(IBD)的发生发展中可能起作用外，还可以调节溃疡性结肠炎(UC)和克罗恩病(CD)的临床病程。这篇综述主要致力于描述这些因素中的一些因素对IBD结果的影响的现有知识，特别强调吸烟和饮食。尽管吸烟对CD和UC易感性的影响已经确定，但它对这两种疾病的临床病程的影响仍然存在争议。在CD中，主动吸烟是术后复发的危险因素。除了这种临床设置，戒烟似乎对那些在疾病诊断时吸烟者的CD患者是有利的，而对于有抵抗性UC的戒烟者可能是有益的。饮食习惯在IBD发展中的作用远未得到很好的证实。此外，食物耐受性很常见，但在IBD患者中通常不一致，因此不能对这些患者提出一般的饮食建议。一般来说，IBD患者的饮食应该尽可能多样化。对于某些饮食成分在IBD中可能的治疗作用，应从CD的肠内营养的初步治疗效果的调查中吸取教训。低脂饮食似乎特别有用。此外，一些脂肪来源，如橄榄油、中链甘油三酯，也许还有omega-3脂肪酸，可能有治疗效果。可发酵纤维可能在预防非活动期UC复发方面发挥作用。(C)2012年白石登。版权所有。
Besides their possible effects on the development of inflammatory bowel disease (IBD), some environmental factors can modulate the clinical course of both ulcerative colitis (UC) and Crohn's disease (CD). This review is mainly devoted to describing the current knowledge of the impact of some of these factors on the outcome of IBD, with special emphasis on smoking and diet. Although the impact of smoking on the susceptibility to develop CD and UC is firmly established, its influence on the clinical course of both diseases is still debatable. In CD, active smoking is a risk factor for postoperative recurrence. Beyond this clinical setting, smoking cessation seems to be advantageous in those CD patients who were smokers at disease diagnosis, while smoking resumption may be of benefit in ex-smokers with resistant UC. The role of dietary habits on the development of IBD is far from being well established. Also, food intolerances are very frequent, but usually inconsistent among IBD patients, and therefore no general dietary recommendations can be made in these patients. In general, IBD patients should eat a diet as varied as possible. Regarding the possible therapeutic role of some dietary components in IBD, lessons should be drawn from the investigation of the primary therapeutic effect of enteral nutrition in CD. Low-fat diets seem to be particularly useful. Also, some lipid sources, such as olive oil, medium-chain triglycerides, and perhaps omega-3 fatty acids, might have a therapeutic effect. Fermentable fiber may have a role in preventing relapses in inactive UC. (C) 2012 Baishideng. All rights reserved.