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A prospective, randomized, controlled, exploratory study of comprehensive dietary advice in ulcerative colitis: impact on disease activity and quality of life

Kyaw, Moe H.; Moshkovska, Tetyana; Mayberry, John

European Journal of Gastroenterology & Hepatology: August 2014 - Volume 26 - Issue 8 - p 910–917
doi: 10.1097/MEG.0000000000000127
Original Articles: Inflammatory Bowel Disease

Objectives The impact of food on relapse in ulcerative colitis has not been clearly defined. The aim of this prospective, randomized-controlled study was to evaluate the impact of comprehensive dietary guidelines on the clinical course of the disease and quality of life in patients with ulcerative colitis.

Materials and methods Patients were allocated randomly to an intervention or a control group. Participants in the intervention group were provided dietary guidelines in the form of an educational booklet that was recommended for use for 4–6 weeks during disease flare, that patients eat little and often (four to six times a day), drink adequate fluids, decrease excess intake of fat, decrease simple carbohydrates and decrease high-fibre foods during flare.

Validated and study-designed questionnaires were used to compare patients’ perceived quality of life, colitis activity scores and eating habits before and following the dietary advice provided.

Results Overall, 112 patients completed the study. Study participants were asked to complete the Inflammatory Bowel Disease Questionnaire and Simple Clinical Colitis Activity Index together with the Food Frequency Questionnaire at 0, 6 and 24 weeks. At 24 weeks, there was a mean reduction in the Simple Clinical Colitis Activity Index score in the intervention group compared with an increase in the score in the control group [−1.304 (P=0.0108) vs. 0.875 (P=0.0249)]. There was a mean increase in the Inflammatory Bowel Disease Questionnaire score in the intervention group compared with a reduction in the score in the control group [7.17 (P=0.126) vs. −3.44 (P=0.205)]. A total of 69% of patients in the intervention group found the dietary advice significantly or moderately helpful.

Conclusion The study suggests that there is likely to be a link between the dietary advice provided and symptomatic improvement. The effect of diet may not occur through the addition or the elimination of single nutrients; rather, each food consumed combines many nutrients that allow for a synergistic or an antagonistic action when present in a certain composition.

Digestive Diseases Centre, University Hospitals of Leicester, Leicester, UK

Correspondence to Moe H. Kyaw, MBBS, MSc, MRCP, MBA, Digestive Diseases Centre, University Hospitals of Leicester, Leicester LE1 5WW, UK Tel: +44 7455012508; e-mail: kyawmhk@gmail.com

Received February 27, 2014

Accepted April 22, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins