How can early nutrition interventions prevent Inflammatory Bowel Disease in children?

Inflammatory bowel disease (IBD) encompassing Crohn’s disease and Ulcerative Colitis is a chronic condition affecting the gastrointestinal tract. In infants, IBD often manifests subtly. Poor weight gain, feeding difficulties or frequent diarrhoea are indicators of an inflamed gut. As the child grows, these struggles evolve to persistent tummy aches, unexplained fatigue, recurrent bathroom visits and growth failure. Early intervention with gut-friendly foods promotes healing and can limit the use of medications. In adolescence, managing IBD is complex due to hormonal changes, academic pressures, and social challenges. Ignorance can cause long-term complications in adulthood, such as intestinal blockages, fistulas, or joint inflammation. Thus, it is crucial to establish a healthy gut microbiome from the very beginning. The foundation of our gut microbiome is laid at birth, shaped by the mode of delivery and initial feeding practices. Disturbance during this delicate beginning can unknowingly set a journey towards IBD. Additional factors such as genetic predisposition, infections, certain medications, smoking, stress contributes to the onset of IBD.

Effective nutrition therapies are targeted at reducing inflammation, sustained remission, and correcting nutrient deficiencies. Below are some nutritional remedies for IBD

• LOW FODMAPS limit the intake of fermentable carbohydrates that cause bloating and flatulence. Substituting with nutrient-dense, easy-digestible foods such as certain fruits, vegetables, gluten-free, and dairy alternatives can soothe the digestive system and support recovery.
• Crohn’s disease diet eliminates food containing emulsifiers, maltodextrin, processed meats, simple sugars, and fatty foods, which can harm the gut barrier or microbiota.
• An anti-inflammatory and Mediterranean diets emphasising whole grains, fruits, vegetables, and omega-3 fatty acids supports gut health and reduces systemic inflammation. Curcumin, a polyphenol found in turmeric, plays a beneficial role in managing IBD.
• Plant-based diets rich in antioxidants and fibre help modulate the gut flora by increasing short-chain fatty acids.

Following modification tips can help to effectively tackle IBD:

• Having small nutrient dense meals to ease digestion
• Adequate hydration to prevent constipation or dehydration from diarrhoea.
• Supplementation of micronutrients to address deficiencies particularly vitamin D, B12 and iron.
• Fibrous plant-based foods are better tolerated by thoroughly chewing and cooking or processing them to a softer consistency.

Dietary restrictions can pose social and emotional challenges, causing feelings of isolation or frustration. Balancing symptoms with guided nutrition plans can facilitate enjoyable food options to help negate these issues. Regular monitoring of weight loss and muscle loss is crucial to prevent the risk of malnutrition It is important to understand that fad diets are misleading. Integrating medical advice with mindful eating, evidence-based guidance and personalised nutrition plans can help in effective management of IBD.

Dr Hiteshi Dhami Shah, Clinical Nutritionist specialist in liver disease and metabolic health, Nanavati Max Super Speciality Hospital, Mumbai