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Lifestyle im Management chronisch-entzündlicher Darmerkrankungen – Teil 1: Ernährung

Lifestyle in the management of inflammatory bowel disease—part 1: nutrition

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Die Gastroenterologie Aims and scope

Zusammenfassung

Hintergrund

Patient*innen mit chronisch-entzündlichen Darmerkrankungen (CED) stellen eine heterogene Gruppe mit unterschiedlichen Symptomen und Komplikationen dar. In Bezug auf die Krankheitsaktivität ist zwischen der Phase des akuten Entzündungsschubs und der Remissionserhaltung zu unterscheiden.

Ziel der Arbeit/Fragestellung

Die vorliegende Arbeit beschreibt die Vorgehensweise und die zu berücksichtigenden Aspekte bei der ernährungstherapeutischen Behandlung von CED-Patient*innen. In Teil 2 dieses Beitrags wird darauf eingegangen, inwieweit Sport- und Bewegungstherapie für diese Patient*innengruppe einen positiven Einfluss auf den Krankheitsverlauf aufweisen können.

Material und Methoden

Die Erfassung des Ernährungszustands wird als Ausgangspunkt der Ernährungstherapie erläutert und anschließend wird die darauf abgestimmte Vorgehensweise zur ernährungstherapeutischen Behandlung in der jeweiligen Krankheitsphase geschildert. Die in den aktuellen Leitlinien vorhandenen Empfehlungen werden unter Berücksichtigung von CED-assoziierten Begleitsymptomen sowie Komplikationen dargestellt.

Ergebnisse und Diskussion

Für CED-Patient*innen ist eine antientzündliche Ernährungsweise auf der Basis einer mediterranen Ernährung empfehlenswert. Dabei stehen für die unterschiedlichen Krankheitsphasen spezifische Ernährungskonzepte zur Verfügung, die im Hinblick auf den individuellen Ernährungszustand anzupassen sind. Das Vorliegen von Mangelzuständen und Begleitsymptomen wie Nahrungsmittelunverträglichkeiten sollte vor Einleitung der Ernährungstherapie diagnostisch abgeklärt werden und die individuelle Behandlung darauf abgestimmt sein.

Abstract

Background

Patients suffering from chronic inflammatory bowel disease (IBD) are a heterogenous patient group with varying symptoms and complications. Concerning disease activity, one has to differentiate between acute flare-ups and remission phases.

Aim

The present publication describes the practice of nutritional therapy in IBD patients, focusing on aspects that have to be considered during this treatment. In addition, the potential positive impact of exercise and physical activity on the course of disease in IBD patients is addressed in part 2 of this article.

Materials and methods

In this publication, we describe how the nutritional status of IBD patients is evaluated at the beginning of the nutritional therapy and how we then proceed with nutritional therapy, based on this evaluation and adapted to the actual disease progress. The recommendations given in the latest guidelines are presented, considering IBD-associated symptoms and complications.

Results and conclusion

We recommend anti-inflammatory nutrition, based on a Mediterranean diet, for IBD patients. Specific nutritional concepts for the respective disease phases have to be adapted to the individual nutritional status of the patient. Diagnosis of nutritional deficiencies, concomitant symptoms, or food intolerances should be checked before starting nutritional therapy. The individual treatment has to consider these results and select appropriate dietetic recommendations for each patient.

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Authors and Affiliations

  1. Hector-Center für Ernährung, Bewegung und Sport, Medizinische Klinik 1 – Gastroenterologie, Pneumologie und Endokrinologie, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland

    Linda Weber, Walburga Dieterich, Hans Joachim Herrmann &  Yurdagül Zopf

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  1. Linda Weber
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  2. Walburga Dieterich
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Correspondence to Yurdagül Zopf.

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L. Weber, W. Dieterich, H. J. Herrmann und Y. Zopf geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Jörg Bojunga, Frankfurt am Main

Mathias Plauth, Dessau-Roßlau

Christian Trautwein, Aachen

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Den Beitrag „Lifestyle im Management chronisch-entzündlicher Darmerkrankungen – Teil 2: Sport“ finden Sie in Ausgabe 4/2023 von Die Gastroenterologie oder online unter https://doi.org/10.1007/s11377-023-00705-3.

English text corrected by: M. Gossen

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Weber, L., Dieterich, W., Herrmann, H.J. et al. Lifestyle im Management chronisch-entzündlicher Darmerkrankungen – Teil 1: Ernährung. Gastroenterologie 18, 255–269 (2023). https://doi.org/10.1007/s11377-023-00704-4

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