Issue 18

Clinical Question

Is there a relationship between dietary fibre and maintenance of remission in either Crohn’s disease (CD) or ulcerative colitis (UC)?

Editor’s Bottom Line

In this study, CD (but not UC) patients who consumed high fibre diets had fewer flares than those on lower fibre diets. Obviously more studies are needed, however, it is likely the higher fibre is functioning as a prebiotic and altering the gut microbiome in a positive way.

Reference

Brotherton CS, Martin CA, Long MD, et al. Avoidance of fiber is associated with greater risk of Crohn’s disease flare in a 6-month period. Clin Gastroenterol Hepatol. 2016 Aug;14(8):1130–6. https://www.ncbi.nlm.nih.gov/pubmed/26748217

Synopsis

Participants were recruited from the Crohn’s and Colitis Foundation Partners Study, an internet-based cohort of adults with CD or UC and indeterminate colitis (IC). At baseline and after 6 months, participants who were in remission provided information about their disease history, medications, and disease activity. As well, a 26-item Dietary Screener Questionnaire collected frequency of consumption of specific food/drink items in the past month.

A total of 1130 CD and 489 UC/IC patients participated with 50% having a disease duration of ≥11 years. There was no association between fibre intake and flares in patients with UC. In CD, those in the highest quartile of fibre and whole grain consumption had an odds ratio of 0.58 for disease flare (95% CI: 0.37–0.90) versus those in the lowest quartile. In CD, high fibre diets had a ~40% less likely risk of disease flare.

Details

Study Design: Prospective observational longitudinal study
Funding: NIH, Patient Centered Outcomes Research Institute, and the Crohn’s and Colitis Foundation of America
Allocation: n/a
Setting: United States
Level of Evidence: 1b (Oxford Levels of Evidence)

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.