Place · Level 3 · Conditions
Inflammatory bowel disease
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In one pass Inflammatory bowel disease is not a menu allergy. Educational content, not medical advice — consult a clinician.
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Chapter 1
Two maps of inflammation
两张发炎的地图
Inflammatory bowel disease is not a menu allergy. Torres 2017 writes Crohn's as chronic inflammation from a tug among genetic susceptibility, environment and microbiota, with innate and adaptive immunity both dysregulated. The typical picture is a young person with abdominal pain, chronic diarrhoea, weight loss and fatigue.
Crohn's can be transmural and can hit any segment from mouth to anus; ulcerative colitis stays in the colonic mucosa. Which segment is hit is what later splits iron, B12 and vitamin D lack. This island lays the map out first. It does not write immune drugs.
Crohn's can be transmural and can hit any segment from mouth to anus; ulcerative colitis stays in the colonic mucosa. Which segment is hit is what later splits iron, B12 and vitamin D lack. This island lays the map out first. It does not write immune drugs.
Chapter 2
The segment decides the gap
哪一段决定缺口
B12 is absorbed almost only in the distal ileum, and needs intrinsic factor from the stomach. ESPEN 2023 (Bischoff) recommendation 64: Crohn's with more than 20 cm of distal ileum resected, or documented deficiency — not unresected ulcerative colitis, which does not predispose to low B12. Iron follows activity: recommendation 11 makes oral iron first-line only when clinically inactive; when active, haemoglobin under 100 g/L, or oral-intolerant, first-line is intravenous iron.
Recommendation 9: check micronutrients regularly, including in remission. Feeling well is not the absorptive surface restored.
Recommendation 9: check micronutrients regularly, including in remission. Feeling well is not the absorptive surface restored.
Chapter 3
Fibre is not a blanket ban
纤维不是一律禁止
Many people go long-term low-fibre at diagnosis. Bischoff recommendation 19 narrows the restriction: Crohn's, already strictured, and already obstructive — the move is adapted texture, or feeding below the stenosis, not deleting fibre from the diet. Ulcerative colitis and Crohn's without stricture still largely take this site's fibre advice.
A long unindicated low-fibre diet has a cost: microbes lose substrate. That is not the same prescription as the three-phase low-FODMAP path on the IBS island.
A long unindicated low-fibre diet has a cost: microbes lose substrate. That is not the same prescription as the three-phase low-FODMAP path on the IBS island.
Chapter 4
Not a diet cure
不是饮食治愈
What you can draw: which layer and which segment is inflamed decides what is missing; fibre restriction follows stricture plus obstruction, not the disease name. The report engine already rewrites generic advice for people who ticked ibd, from ESPEN. This island lays out the anatomy behind that card. It does not replace gastroenterology, and it does not write exclusive enteral nutrition or a named diet as a cure.
References · 2
- Torres, J., Mehandru, S., Colombel, J. F., & Peyrin-Biroulet, L. (2017). Crohn's disease. The Lancet, 389(10080), 1741-1755. Seminar: Crohn's is transmural inflammation that can involve any segment of the gut, from interplay of genetic susceptibility, environment and microbiota with dysregulated innate and adaptive immunity. Typical presentation: abdominal pain, chronic diarrhoea, weight loss, fatigue. 10.1016/S0140-6736(16)31711-1
- Bischoff, S. C., Bager, P., Escher, J., Forbes, A., Hébuterne, X., Hvas, C. L., et al. (2023). ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clinical Nutrition, 42(3), 352-379. 10.1016/j.clnu.2022.12.004