Nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of disease. With regards to etiology, there are pediatric data, mainly from case-control studies, which suggest that some dietary habits (for example consumption of animal protein, fatty foods, high sugar intake) may predispose patients to IBD onset. As for disease treatment, exclusive enteral nutrition (EEN) is an extensively studied, well established, and valid approach to the remission of pediatric Crohn's disease (CD). Apart from EEN, several new nutritional approaches are emerging and have proved to be successful (specific carbohydrate diet and CD exclusion diet) but the available evidence is not strong enough to recommend this kind of intervention in clinical practice and new large experimental controlled studies are needed, especially in the pediatric population. Moreover, efforts are being made to identify foods with anti-inflammatory properties such as curcumin and long-chain polyunsaturated fatty acids n-3, which can possibly be effective in maintenance of disease. The present systematic review aims at reviewing the scientific literature on all aspects of nutrition in pediatric IBD, including the most recent advances on nutritional therapy.
OBJETIVO: Se realizó una revisión sistemática para Medicina Complementaria y Alternativa [CAM] tal como se define por el Instituto Nacional de Salud en la enfermedad inflamatoria intestinal [EII], es decir, la enfermedad de Crohn [CD] y la colitis ulcerosa [UC], con la excepción de la dieta y la suplementos nutricionales y terapias manipulativas.
MÉTODOS: Una búsqueda informatizada de las bases de datos [Cochrane Library, de Pubmed / Medline, PsychINFO y Scopus] a marzo 2014 se llevó a cabo. Se revisaron las secciones de referencia de los estudios originales y revisiones sistemáticas en idioma Inglés de CAM en la EII, EC y CU. Ensayos controlados aleatorios [ECA] y ensayos controlados [TC] fueron remitidos y evaluados utilizando el riesgo Cochrane de herramienta de sesgo.
RESULTADOS: Un total de 26 ECA y 3 CT para la medicina a base de hierbas, por ejemplo, gel de aloe-vera, andrographis paniculata, artemisia absinthium, producto alimenticio cebada, Boswelia, el cannabis, la curcumina, el aceite de onagra, Myrrhinil intest®, plantago ovata, la silimarina, sophora, tormentil, wheatgrass jugo y ajenjo; 1 ECA para ovata suis trichuris; 7 ECA para las intervenciones de mente / cuerpo, tales como la modificación del estilo de vida, la hipnoterapia, entrenamiento de relajación y la atención; y 2 ECA en la acupuntura; fueron encontrados. Riesgo de sesgo era bastante heterogéneo. Mejor se encontraron pruebas de la terapia a base de hierbas, es decir, plantago ovata y curcumina en la terapia de mantenimiento de la UC, el ajenjo en CD, mente / terapia corporal y auto-intervención en la Universidad de California, y la acupuntura en la CU y CD.
CONCLUSIONES: Las terapias complementarias y alternativas podrían ser eficaces para el tratamiento de enfermedades inflamatorias del intestino; Sin embargo, dado el escaso número de ensayos y la calidad metodológica de los ensayos heterogéneos, más a fondo es necesaria la investigación.
Nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of disease. With regards to etiology, there are pediatric data, mainly from case-control studies, which suggest that some dietary habits (for example consumption of animal protein, fatty foods, high sugar intake) may predispose patients to IBD onset. As for disease treatment, exclusive enteral nutrition (EEN) is an extensively studied, well established, and valid approach to the remission of pediatric Crohn's disease (CD). Apart from EEN, several new nutritional approaches are emerging and have proved to be successful (specific carbohydrate diet and CD exclusion diet) but the available evidence is not strong enough to recommend this kind of intervention in clinical practice and new large experimental controlled studies are needed, especially in the pediatric population. Moreover, efforts are being made to identify foods with anti-inflammatory properties such as curcumin and long-chain polyunsaturated fatty acids n-3, which can possibly be effective in maintenance of disease. The present systematic review aims at reviewing the scientific literature on all aspects of nutrition in pediatric IBD, including the most recent advances on nutritional therapy.
