Q. Nutritional Management in Inflammatory Bowel Disease?

Adequacy of nutritional needs and minimizing stress on the inflamed or narrowed segment of the bowel are the main principles of nutrition management.

To decrease eating associated symptoms and decreased bowel activity during healing, patients hospitalized for IBD (Inflammatory Bowel Disease) are placed on a "bowel rest" programme, which involves reduction in oral intake, clear liquids and low residue foods. This is normally done to achieve the following:

1. Decrease the absorptive work of the bowel and provide rest.

2. Minimize mechanical trauma caused by the passage of food.

3. Decreased diet associated secretions (acid, enzymes) that may aggravate inflammation.

The diet should be liberal in protein and calories and should be sufficient to maintain or restore weight/support growth of children and adolescents. Supplementation with multivitamin preparations (1-5 times above RDA) in necessary as this condition precipitates deficiency of many nutrients, decreases absorption and increases requirements.