IBD Evidence

Dieta

Dietak hesteetako hanturazko gaixotasuna tratatzen al du?

Dieta-esku-hartze batek gutxi gorabehera esteroideek bezain ondo eragiten du erremisioa. Gainerako gehienek internetek iradokitzen duena baino babes askoz txikiagoa dute.

Eguneratuta 2 min irakurri 36 aipamenak Emaitzen indarra 4/5

Hiru pertsonako barne medikuntzako gela batean egindako ohea
玄史生 · CC0 · Wikimedia Commons

Nutrizio enteral esklusiboa

Sei-zortzi astez esklusiboki hartutako formula likidozko dieta batek berbizialdia eragiten du Crohn gaixotasun pediatrikoan, kortikoideen tasa konparagarrietan — haurretan steroideak arazotsu bihurtzen dituen hazkunde-inhibiziorik gabe. Europako praktika pediatriko askoren lehen aukera da.

Zergatik funtzionatzen duen ez dago benetan argi. Azalpen hautagaien artean dieta-antigenoak kentzea, mikrobiota aldatzea, elikagai-gehigarriak kentzea eta soilik nutrizio osoa ematea daude. Ziurgabetasun horrek garrantzia du, izan ere, horregatik ezin dizu inork esan dieta arrunt baten zein zati kendu behar diren eragin bera lortzeko.

Nutrizio enterala berbizialdia eragiteko

Zuntza: eztabaidatua, jendeak uste duen moduan ez

Berrikuspen sistematiko eta metaanalisi batek zuntz altuko dietak aztertu zituen Crohn gaixotasunean [2]. Irudia hondar gutxiko aholku tradizionalak iradokitzen zuena baino aldekoagoa da — baina laburpenetan galtzen den salbuespen garrantzitsu batekin.

Estenosia duen gaixotasun aktiboan, zuntz iraungabezko bolumen handiko elikagaiek obstrukzioa eragin dezakete. Hori arazo mekanikoa da, ez inflamatorioa, eta horregatik huts egiten du aholku orokorrak. Estenosirik gabeko gaixotasun geldiroan, zuntzari buruzko ebidentzia orokorra aplikatzen da — ikus gure hesteak-garuna ebidentzia gunea.

Gainerako guztia

Dieta-planteamenduak ebidentziaren indarraren arabera
IkuspegiaEbidentziaEpaia
Nutrizio enteral esklusiboaSendoa, Crohn pediatrikoanBenetako tratamendua
Crohn Gaixotasunaren Baztertze DietaGero eta ebidentzia ausazkotu gehiagoItxaropentsua
Eredu mediterraneoaOsasun orokorra, HHGrako berariazko ebidentzia mugatuaAukera arrazoizkoa lehenespenez
FODMAP baxuaSintomen arintzea, ez inflamazioa [4]Sintomatikoa soilik
Karbohidrato Espezifikoen DietaMugatua, nahasiaFrogatu gabea
Glutenik gabea, zeliakia izan gabeHHGrako berariazko ebidentziarik ezEz dago adierazita
IgG probetan oinarritutako baztertzeaBaliozkotasunik ezSaihestu

FODMAP lerroak azpimarra merezi du, gehien gaizki ulertzen dena delako. FODMAP baxuko dietek nabarmen murriztu dezakete hantura eta mina HHGn — eta ez dute inflamazioa murrizten. Inflamazioak jarraitzen duen bitartean hobeto sentitzea benetan emaitza arriskutsua da, eta horregatik sintomen araberako dieta-kudeaketak jarraipen objektiboarekin batera egon behar du, hura ordezkatu beharrean.

Elikagai eragileak

HHGko elikagai-intolerantzia eta baztertze-dietei buruzko berrikuspen sistematiko batek pazienteek dagoeneko dakitena aurkitzen du: elikagai eragileak errealak dira, banakakoak, eta pertsonen artean ez-koherenteak. Ez dago zerrenda baliozkoturik. Metodo fidagarri bakarra jarraipen pertsonal sistematikoa da — hori datu-arazoa da, ez ezagutza-arazoa, eta horregatik zure patroi propioa ikasten duen eskaneatze-aplikazio bat liburuxka inprimatu bat baino erabilgarriagoa da.

Sphincterotomia ondoren Vater papilaren endoskopi ikuspegia, irekiduratik bilaren drainatzearekin
Doctor roach · CC BY 4.0 · Wikimedia Commons

Ohiko galderak

HHG dietaz bakarrik trata dezaket?
Nutrizio enteral esklusiboak berbizialdia eragin dezake, batez ere Crohn pediatrikoan. Ez da frogatu dieta arrunt batek ere mantentze-terapia ordezkatzen duenik.
Zuntza saihestu behar al dut?
Ez, oro har. Metaanalisia aholku zaharra baino aldekoagoa da [2] — estenosia duen gaixotasunerako salbuespen errealarekin.
Elikagai-intolerantzia odol-probek laguntzen al dute?
IgG elikagai-probek ez dute baliozkotasunik elikagai eragileak identifikatzeko, eta modu fidagarrian murrizketa beharrezkoak ez direnak eragiten dituzte.
Merezi al du FODMAP baxuko dieta probatzea?
Sintometarako, agian, dietista baten laguntzarekin eta berriz sartuz. Ez du inflamazioa tratatzen.
Orri honen atzean dagoen froga 20 argitalpenen ikerketa motaren arabera osaketa erakusten duen barra pilatua. 884meta-analysis (8)randomised trial (8)review (4)
20 argitalpen, 1994–2026. Horrek probak eta sintesiak biltzen dituen nahasketa bat da, eta horretatik kausaren inguruko baieztapen bat egiteko arrazoizkoa den posizioa da. Iturria: orri honen aipamen zerrenda, behean.

Erreferentziak

Hemen azpiko aipamen guztiak PubMed-en edo DOI bidezko jatorrizko peer-reviewed erregistroari lotzen diote. Hemen ez dago mediku aholkurik ordezkatzeko.

  1. Mediterranean diet in treatment of inflammatory bowel disease: A systematic review and meta-analysis Singh A, Rana U, Chandnani S, et al. · Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026 · Meta-analysis DOIPubMed 41803562
  2. Study Design Complexity and Participant Completion in Dietary Trials for Inflammatory Bowel Disease: A Systematic Review and Metaresearch Study Gregersen L, Moos C, Hikmat Z, et al. · Advances in nutrition (Bethesda, Md.) · 2026 · Systematic review DOIPubMed 41825595Full text
  3. Pre-Illness Index-Based Dietary Patterns and Inflammatory Bowel Disease Risk: A Systematic Review and Meta-Analysis Meng F, Zhang T, Meng X, et al. · Nutrition reviews · 2025 · Meta-analysis DOIPubMed 40700526
  4. Using Diet to Treat Inflammatory Bowel Disease: A Systematic Review Gleave A, Shah A, Tahir U, et al. · The American journal of gastroenterology · 2025 · Systematic review DOIPubMed 39056556
  5. Efficacy of a Low-FODMAP Diet on the Severity of Gastrointestinal Symptoms and Quality of Life in the Treatment of Gastrointestinal Disorders-A Systematic Review of Randomized Controlled Trials Kuźmin L, Kubiak K, Lange E · Nutrients · 2025 · Systematic review DOIPubMed 40573159Full text
  6. AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease: Expert Review Hashash JG, Elkins J, Lewis JD, et al. · Gastroenterology · 2024 · Clinical guideline DOIPubMed 38276922
  7. Is There Evidence of Crohn's Disease Exclusion Diet (CDED) in Remission of Active Disease in Children and Adults? A Systematic Review Correia I, Oliveira PA, Antunes ML, et al. · Nutrients · 2024 · Systematic review DOIPubMed 38613020Full text
  8. Efficacy of different dietary therapy strategies in active pediatric Crohn's disease: a systematic review and network meta-analysis Ma J, Chong J, Qiu Z, et al. · PeerJ · 2024 · Meta-analysis DOIPubMed 39686992Full text
  9. High-Fiber Diet and Crohn's Disease: Systematic Review and Meta-Analysis Serrano Fernandez V, Seldas Palomino M, Laredo-Aguilera JA, et al. · Nutrients · 2023 · Meta-analysis DOIPubMed 37513532Full text
  10. Dietary Interventions in Ulcerative Colitis: A Systematic Review of the Evidence with Meta-Analysis Herrador-López M, Martín-Masot R, Navas-López VM · Nutrients · 2023 · Meta-analysis DOIPubMed 37836478Full text
  11. Interventions for the management of abdominal pain in Crohn's disease and inflammatory bowel disease Sinopoulou V, Gordon M, Akobeng AK, et al. · The Cochrane database of systematic reviews · 2021 · Systematic review DOIPubMed 34844288Full text
  12. Systematic Review of the Effects of Oat Intake on Gastrointestinal Health Valido E, Stoyanov J, Bertolo A, et al. · The Journal of nutrition · 2021 · Systematic review DOIPubMed 34486656
  13. Dietary interventions for induction and maintenance of remission in inflammatory bowel disease Limketkai BN, Iheozor-Ejiofor Z, Gjuladin-Hellon T, et al. · The Cochrane database of systematic reviews · 2019 · Meta-analysis DOIPubMed 30736095Full text
  14. Environmental Risk Factors for Inflammatory Bowel Diseases: An Umbrella Review of Meta-analyses Piovani D, Danese S, Peyrin-Biroulet L, et al. · Gastroenterology · 2019 · Meta-analysis DOIPubMed 31014995
  15. ESPEN guideline: Clinical nutrition in inflammatory bowel disease Forbes A, Escher J, Hébuterne X, et al. · Clinical nutrition (Edinburgh, Scotland) · 2017 · Systematic review DOIPubMed 28131521
  16. Nutrition in Pediatric Inflammatory Bowel Disease: From Etiology to Treatment. A Systematic Review Penagini F, Dilillo D, Borsani B, et al. · Nutrients · 2016 · Systematic review DOIPubMed 27258308Full text
  17. British Dietetic Association evidence-based guidelines for the dietary management of Crohn's disease in adults Lee J, Allen R, Ashley S, et al. · Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2014 · Clinical guideline DOIPubMed 24313460
  18. Effect of Five Dietary Emulsifiers on Inflammation, Permeability, and the Gut Microbiome: A Placebo-controlled Randomized Trial Wellens J, Vanderstappen J, Hoekx S, et al. · Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026 · Randomised controlled trial DOIPubMed 40816342
  19. A Randomised Controlled Trial Comparing the Effects of Personalised Diet and Physical Activity Intervention Versus Usual Care on Cardiometabolic Risk Factors in Adults with Inactive Inflammatory Bowel Disease Yap JM, Wall CL, Meredith-Jones K, et al. · Nutrients · 2026 · Randomised controlled trial DOIPubMed 41829955Full text
  20. Evidence for a Modulatory Effect of a 12-Week Pomegranate Juice Intervention on the Transcriptional Response in Inflammatory Bowel Disease Patients Reducing Fecal Calprotectin Levels: Findings From a Proof-of-Principle Study Minato I, Mena P, Ricciardiello L, et al. · Molecular nutrition & food research · 2025 · Randomised controlled trial DOIPubMed 40255128Full text
  21. Effects of bromelain supplementation on disease activity and quality of life in patients with ulcerative colitis: a randomized, triple-blind, placebo-controlled study Delgarm P, Mokhtare M, Ebrahimi Daryani N, et al. · Scientific reports · 2025 · Randomised controlled trial DOIPubMed 41315628Full text
  22. Whole Food Diet Induces Remission in Children and Young Adults With Mild to Moderate Crohn's Disease and Is More Tolerable Than Exclusive Enteral Nutrition: A Randomized Controlled Trial Aharoni-Frutkoff Y, Plotkin L, Pollak D, et al. · Gastroenterology · 2025 · Randomised controlled trial DOIPubMed 40553742
  23. The use of the Crohn's disease exclusion diet (CDED) in adults with Crohn's disease: A randomized controlled trial Pasta A, Formisano E, Calabrese F, et al. · European journal of clinical investigation · 2025 · Randomised controlled trial DOIPubMed 39853756
  24. The Crohn's disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn's disease (CDED-AD): an open-label, pilot, randomised trial Yanai H, Levine A, Hirsch A, et al. · The lancet. Gastroenterology & hepatology · 2022 · Randomised controlled trial DOIPubMed 34739863
  25. Metabolome Changes With Diet-Induced Remission in Pediatric Crohn's Disease Ghiboub M, Penny S, Verburgt CM, et al. · Gastroenterology · 2022 · Randomised controlled trial DOIPubMed 35679949
  26. Effects of Low FODMAP Diet on Symptoms, Fecal Microbiome, and Markers of Inflammation in Patients With Quiescent Inflammatory Bowel Disease in a Randomized Trial Cox SR, Lindsay JO, Fromentin S, et al. · Gastroenterology · 2020 · Randomised controlled trial DOIPubMed 31586453
  27. Treatment of Active Crohn's Disease With an Ordinary Food-based Diet That Replicates Exclusive Enteral Nutrition Svolos V, Hansen R, Nichols B, et al. · Gastroenterology · 2019 · Randomised controlled trial DOIPubMed 30550821
  28. Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial Levine A, Wine E, Assa A, et al. · Gastroenterology · 2019 · Randomised controlled trial DOIPubMed 31170412
  29. Treatment of Crohn's Disease with an IgG4-Guided Exclusion Diet: A Randomized Controlled Trial Gunasekeera V, Mendall MA, Chan D, et al. · Digestive diseases and sciences · 2016 · Randomised controlled trial DOIPubMed 26809868
  30. Nutrition support in inflammatory bowel disease Lewis JD, Fisher RL · The Medical clinics of North America · 1994 · Randomised controlled trial DOIPubMed 7967919
  31. Chronic, Noninfectious Diarrhea: A Review Singh P, Lee A, Sheth NM, et al. · JAMA · 2026 · Review DOIPubMed 41770539
  32. Diet, Gut Microbiome, and Microbial Metabolites in Inflammatory Bowel Disease: From Functional Dysbiosis to Precision Nutrition Bozic J, Santic R, Zivkovic PM, et al. · International journal of molecular sciences · 2026 · Review DOIPubMed 42352981Full text
  33. Dietary therapies for adult and pediatric inflammatory bowel disease Deas J, Shah ND, Konijeti GG, et al. · Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2024 · Review DOIPubMed 38505875
  34. Considerations in Paediatric and Adolescent Inflammatory Bowel Disease Vuijk SA, Camman AE, de Ridder L · Journal of Crohn's & colitis · 2024 · Review DOIPubMed 39475081Full text
  35. Mild Crohn's Disease: Definition and Management Claytor J, Kumar P, Ananthakrishnan AN, et al. · Current gastroenterology reports · 2023 · Review DOIPubMed 36753033
  36. Examining dietary interventions in Crohn's disease Chen L, Srinivasan A, Vasudevan A · World journal of gastroenterology · 2024 · Journal article DOIPubMed 39350785Full text

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