Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2012, vol. 21, nr 1, January-February, p. 5–11

Publication type: editorial article

Language: English

The Influence of Deficiencies of Essential Trace Elements and Vitamins on the Course of Crohn’s Disease

Wpływ niedoborów niezbędnych pierwiastków śladowych i witamin na przebieg choroby Crohna

Dorota Waśko-Czopnik1,, Leszek Paradowski1,

1 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

Abstract

In patients with Crohn’s Disease (CD), malnutrition is frequently observed and is an important complication, frequently associated with nutritional deficiencies, especially vitamins (both waterand fat-soluble) and essential trace elements. It is often a result of the disease activity, poor oral intake and/or restrictive diets. Nutrition plays an important role in disease management and helps to maintain remission in CD patients. Deficiencies occur in patients with active Crohn’s disease, and also in those in remission. Specific supplementation of vitamins and microand macronutrients might be helpful or even necessary in this group of patients. This review outlines the most frequent nutritional deficiencies and their complications in relation to the Crohn’s Disease Activity Index, and provides an overview of therapeutic perspectives for CD patients in adult patients with inflammatory bowel disease (IBD). Biological therapy, which is being used with increasing frequency, seems not only to mitigate the inflammatory process in the gastrointestinal tract, but also has significant impact on the nutritional status of patients with Crohn’s disease.

Streszczenie

Niedożywienie jest często obserwowane u pacjentów z chorobą Crohna, stanowi poważne powikłanie i jest związane z niedoborem składników pokarmowych, zwłaszcza witamin (rozpuszczalnych zarówno w wodzie, jak i tłuszczach) oraz niezbędnych pierwiastków śladowych. Zazwyczaj stan taki jest rezultatem nasilonej aktywności choroby, niedostatecznej podaży pokarmu i restrykcyjnej diety. Odpowiednie odżywienie odgrywa kluczową rolę w leczeniu choroby i przyczynia się do uzyskania pełniejszej remisji. Niedobory te występują nie tylko u pacjentów z aktywną chorobą Crohna, ale także podczas remisji, dlatego też odpowiednia suplementacja witamin, mikroi makroelementów powinna być pomocna, a nawet niezbędna w tej grupie chorych. W pracy omówiono najczęściej występujące niedobory pokarmowe i powikłania z nich wynikające w zależności od indeksu aktywności choroby oraz przedstawiono przegląd możliwości ich leczenia u dorosłych pacjentów z IBD. Coraz szerzej stosowane leczenie biologiczne wydaje się skuteczne nie tylko w aspekcie zahamowania procesu zapalnego w przewodzie pokarmowym, ale także wywierania znacznego wpływu na stan odżywienia u pacjentów z chorobą Crohna.

Key words

trace elements, vitamins, malnutrition, Crohn’s disease, nutritional deficiencies

Słowa kluczowe

pierwiastki śladowe, witaminy, niedożywienie, choroba Crohna, niedobory pokarmowe

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