Letter From the Editors 

Welcome to the October Newsletter! We’re excited to bring our IBD community the latest news about nutrition and IBD.

This month, we’ve enriched our resources to support you, with updates to our partial enteral nutrition (PEN) webpage, offering more comprehensive guidance and our latest article on navigating IBD and fatigue, a common yet often overlooked challenge for many. 

For those with a sweet tooth, we are highlighting sweet treat recipes.

At the end of this newsletter, you’ll find a short survey. We would love to hear your feedback on how we can improve our resources to better serve you!

The Ins and Outs of PEN
Partial Enteral Nutrition

Partial enteral nutrition is consuming 35-50% of daily calories from over-the-counter meal replacement formula while allowing the remaining intake from healthy whole foods.

Partial enteral nutrition to prolong Crohn’s disease remission

⭐ The dose of formula matters, with many healthcare providers encouraging closer to 50% of daily requirements from formula.

⭐ Children and adults with Crohn’s disease receiving medications and formula have shown an increase in remission rates, with up to 64% of patients achieving clinical remission,  and a decrease in flares. 

📚 Further reading:
ECCO-ESPGHAN 2020 guidelines  &  ECCO 2024 guidelines 

Partial enteral nutrition and biologics to induce remission of Crohn’s disease

⭐ About 30-75% of patients do not respond to biologics alone 

⭐ Partial enteral nutrition plus biologics may lead to
    an increase in the efficacy of medications and better induction outcomes

⭐ Which patients with Crohn’s disease may benefit?

✅ Patients with fistulizing disease
✅ Patients who are intolerant to biologics
✅ Patients who do not respond to increasing doses of biologics

📚 Further reading:

Partial enteral nutrition as add-on to biologics in patients with refractory and difficult-to-treat Crohn’s disease: 

Partial enteral nutrition to improve surgery outcomes

⭐ Surgery presents unique nutritional challenges, particularly for patients who are malnourished

⭐ Personalized nutrition support in patients undergoing surgery leads to:

✅ Improved disease activity

✅⬇ hospital length of stay

✅⬇ 30-day readmission rates

✅⬇ risk of postoperative complications

⭐ Differences exist between pre- and post-surgical nutrition

📚 Further reading: Nutritional assessment and optimization before IBD surgery: 

⚠ Ask for the supervision of a registered dietitian before replacing any of your meals with an oral nutritional supplement.

📚 Find out more about what emerging science says on the role of meal replacement formulas in IBD: 

Highlights from the Latest Research Articles

💡 Diet and nutrition for IBD is more than just counting calories 👉 The four pillars of evidence-based dietary management in patients with IBD include:

✅ Improve nutrition status

✅ Treat active intestinal inflammation

✅ Improve non-inflammatory issues

✅ Promote an overall healthy diet 

📚 Further reading: Evidence-based dietary management of inflammatory bowel disease 

💡A new research project led by Oriana Damas seeks to develop and test a culturally tailored anti-inflammatory diet for US Hispanic patients with ulcerative colitis

✅ Culturally tailored, anti-inflammatory diet for 8 weeks

✅ Participants will provide feedback on the recipes used 

✅ Examples of staples with the potential to improve inflammation and symptoms: rice dishes, yams, yuca, Latin soups, papaya, guava, and mango

📚 Further reading: Studying a Culturally Tailored, Anti-inflammatory Diet’s Impact on Hispanic/LatinX Patients with Ulcerative Colitis 

💡Repetitive antibiotic treatment erodes the mucus barrier in mice, which might explain why these drugs have long been associated with a higher IBD risk

✅ Our immune system is separated from the trillions of intestinal microbes by a thin layer of impenetrable mucus

✅ Multiple antibiotics all impaired the mucus barrier and led to penetration of bacteria into close contact with the host epithelium

✅ Antibiotics affected the mouse directly, and this effect was independent of the microbiota

📚 Further reading: Antibiotics damage the colonic mucus barrier in a microbiota-independent manner 

7 Ways to Combat Fatigue with Inflammatory Bowel Disease 

Living with IBD can often bring challenges like fatigue, which can feel overwhelming. However, there are ways to regain energy and improve your quality of life. In this article, you’ll discover seven practical tips to help combat fatigue while managing IBD. These strategies, from dietary adjustments to lifestyle changes, are designed to support your overall well-being.

Ostomies are Life-Savers

October 5th was Ostomay Awareness  Day. We support ostomates around the world in raising awareness of the impact ostomies can have on their lives.        

We appreciate our organizational partners United Ostomy Associations of America, Inc. (UOAA) and Girls with Guts for providing support to patients, including the following resources.

- GWG’s Ostomy Fact Sheets help patients manage their ostomies by offering information on supplies, clothing, exercise, and more!

- On UOAA’s Diet + Nutrition section, patients can find a downloadable guide “Eating with an Ostomy,” which provides information on maintaining adequate nutrition with an ostomy. 

Recipes 

We are working hard to continue to expand our recipe database. We've got festive fall recipes and some treats, no tricks, for Halloween!  

Pumpkin Turmeric Gummies  Thai Red Curry with Chicken Apricot Pistachio Biscotti

Nutritional Therapy for IBD Survey

We welcome feedback from everyone—whether you're a patient with IBD, a caregiver, or a healthcare professional. Let us know your thoughts on the Nutritional Therapy for IBD resources and what diet and nutritional therapy topics you'd like to see more of, so we can tailor our content to your interests.

We greatly appreciate your time and participation in this 10-minute survey, which can be completed until October 26. 

To Our Readers

If you find our content helpful, please consider donating to support our efforts in improving nutritional care for IBD.

Know someone with IBD looking for information on evidence-based nutritional therapy? Feel free to forward them this email!

Thank you, and see you next month!

The Nutritional Therapy for IBD Team

At Nutritional Therapy for IBD, we are grateful for the collaboration and support of our Corporate Partners!

*Please note that Nutritional Therapy for IBD does not provide medical advice. The content provided here is for informational purposes only. Patients should always talk with their healthcare providers before changing their diet.*