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Audio / Video Poster

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Introduction

Every year, there are increasing bodies of evidence highlighting the positive therapeutic effect of the introduction and elimination of various dietary elements in inflammatory bowel disease. Despite this, nutrition therapy in ulcerative colitis (UC) is not systematically well studied. Resultingly, no recommendations for its implementation into clinical practice currently exist.

Aims & Methods

We aimed to systematically review and summarise the most up to date evidence on anti-inflammatory diet (AID) interventions in ulcerative colitis. We hoped to help clinicians make more informed decisions regarding AID implementation for their UC patients. We performed a systematic electronic search in MEDLINE, EMBASE and Scopus from inception to December 2022, to retrieve human studies investigating the effects of AID intervention on UC patients.

Results

998 papers were screened, 101 were assessed for eligibility and 13 were selected for inclusion in this systematic review. There were 627 participants in total and six studies were randomised controlled trials (RCTs). In our analysis, we discovered that most the papers assessed showed AID had a statistically and clinically significant, positive therapeutic effect on UC (10/13). We also found AID intervention could induce and maintain remission, reduce colectomy rates, and improve patient quality of life. Efficacy was shown in mild, moderate, and severe forms of UC, and when initiated as either a monotherapy or adjunct with conventional therapy.

Conclusion

Our study is the first systematic review to both investigate and indicate that AID interventions may be efficacious in reducing UC disease severity for both patient-reported symptoms, and endoscopically or biochemically observed signs. We believe however that due to the lack of high quality studies, more RCTs are needed to strengthen the evidence behind this promising hypothesis.

NUTRITION THERAPY IN ULCERATIVE COLITIS, A SYSTEMATIC REVIEW

Samuel Sartie 1, Aditya Sheth 2, Sepehr Maleki 3, Noha Nasef 4, Kamran Rostami 2

1 University Of Otago, Wellington, New Zealand, Wellington, New Zealand

2 MidCentral DHB Palmerston North Hospital, Palmerston North, New Zealand

3 University of Tabriz, Tabriz, Iran, Islamic Republic of

4 Massey University, Palmerston North, New Zealand|||Massey University, Palmerston North, New Zealand

Conference

UEG Week Copenhagen 2023

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

PP 04 Nutrition (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Podcast Episode

UEG Podcast

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Best of UEG Week - IBD

Pradeep Mundre 1, Julia Mayerle 2, Tim Raine 3

1 Bradford Teaching Hospitals NHS trust, Leeds, United Kingdom

2 Klinikum der LMU München-Grosshadern, München, Germany

3 Cambridge University Hopsital NHS Foundation Trust, Cambridge, United Kingdom

Topics

IBD

Published

2023

UEG Standards and Guidelines

Position Paper

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Abstract

Objectives

Jejunal tube feeding (JTF) is increasingly becoming the standard of care for children in whom gastric tube feeding is insufficient to achieve caloric needs. Given a lack of a systematic approach to the care of JTF in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimize its utility and safety.

Methods

A group of members of the Gastroenterology and Nutrition Committees of the European Society of Paediatric Gastroenterology Hepatology and Nutrition and of invited experts in the field was formed in September 2016 to produce this clinical guide. Seventeen clinical questions treating indications and contraindications, investigations before placement, techniques of placement, suitable feeds and feeding regimen, weaning from JTF, complications, long-term care, and ethical considerations were addressed.

A systematic literature search was performed from 1982 to November 2018 using PubMed, the MEDLINE, and Cochrane Database of Systematic Reviews. Grading of Recommendations, Assessment, Development, and Evaluation was applied to evaluate the outcomes.

During a consensus meeting, all recommendations were discussed and finalized. In the absence of evidence from randomized controlled trials, recommendations reflect the expert opinion of the authors.

Results

A total of 33 recommendations were voted on using the nominal voting technique.

Conclusions

JTF is a safe and effective means of enteral feeding when gastric feeding is insufficient to meet caloric needs or is not possible. The decision to place a jejunal tube has to be made by close cooperation of a multidisciplinary team providing active follow-up and care.

The Use of Jejunal Tube Feeding in Children

Ilse Broekaert

Publisher

European Society for Paediatric Gastroenterology, Hepatology and Nutrition

Guideline

Position Paper

Topics

Paediatrics Small Intestine & Nutrition

Citation

Journal of Pediatric Gastroenterology and Nutrition, 69: 239-258

Published

2019

UEG Podcast Episode

Journal Podcast

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Episode 4: UEG Journal August Spotlight

Mohsan Subhani, Maria Manuela Estevinho, Umair Kamran, Nigel Trudgill

Published

2025

UEG Standards and Guidelines

Position Paper

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Abstract

Objectives

Given a lack of a systematic approach to the use of breath testing in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimise its utility and safety.

Methods

Nine clinical questions regarding methodology, interpretation, and specific indications of breath testing and treatment of carbohydrate malabsorption were addressed by members of the Gastroenterology Committee (GIC) of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN).

A systematic literature search was performed from 1983 to 2020 using PubMed, the MEDLINE and Cochrane Database of Systematic Reviews. Grading of Recommendations, Assessment, Development, and Evaluation was applied to evaluate the outcomes.

During a consensus meeting, all recommendations were discussed and finalised. In the absence of evidence from randomised controlled trials, recommendations reflect the expert opinion of the authors.

Results

A total of 22 recommendations were voted on using the nominal voting technique. At first, recommendations on prerequisites and preparation for as well as on interpretation of breath tests are given. Then, recommendations on the usefulness of H2-lactose breath testing, H2-fructose breath testing as well as of breath tests for other types of carbohydrate malabsorption are provided. Furthermore, breath testing is recommended to diagnose small intestinal bacterial overgrowth (SIBO), to control for success of Helicobacter pylori eradication therapy and to diagnose and monitor therapy of exocrine pancreatic insufficiency, but not to estimate oro-caecal transit time (OCTT) or to diagnose and follow-up on celiac disease.

Conclusions

Breath tests are frequently used in paediatric gastroenterology mainly assessing carbohydrate malabsorption, but also in the diagnosis of small intestinal overgrowth, fat malabsorption, H. pylori infection as well as for measuring gastrointestinal transit times. Interpretation of the results can be challenging and in addition, pertinent symptoms should be considered to evaluate clinical tolerance.