In Italy alone, Crohn’s disease affects about 150,000 thousand people, in 1 out of 4 cases diagnosed before the age of 20: people who live with this pathology increasingly need to have access to clear and timely information on the diet to follow . Just to open a dialogue between doctors and patients, the meeting “New frontiers of the pharmacological treatment of Mice” was held last Saturday at the San Raffaele hospital in Milan.
The event – reads a note – was organized by the health facility in collaboration with the Amici onlus patient association and with the unconditional support of Nestlé Health Science. A panel of experts made itself available to patients and caregivers, to answer their questions and outline a 360-degree scenario on Mice and their treatment from childhood to adulthood, with advice and suggestions for better management of the Crohn’s disease, with special attention to the crucial issue of nutrition and diet. One aspect, that of nutrition, which has important repercussions on health, also at a psycho-affective and social level, both in adults and in pediatric patients: the need to exclude some foods, to avoid a flare-up of the disease, is an important stress.
In fact, for two thirds of patients with Crohn’s disease (the most common among cats), nutrition has a strong impact on the quality of life, with 1 in 4 people – continues the note – who feel frustrated because they don’t know how a certain food or drink can interact with the disease. And with more than a third unable to enjoy food at mealtimes. The need to follow a specific diet – it was reiterated – therefore goes hand in hand with the need to receive clearer and more comprehensive information from gastroenterologists and nutritionists. For the majority of patients, the diet followed is the result of a long experiment based on trial and error, self-regulation and listening to one’s body: this is the scenario that emerged from the survey by the EngageMinds Hub center of the University Cattolica del Sacro Cuore in the context of the social campaign “Crohnlive – Stories of young people that Crohn’s disease cannot stop” promoted by Nestlé Health Science and in collaboration with the Amici Onlus association.
During the meeting, coordinated by Professor Silvio Danese, director of the Irccs Gastroenterology and digestive endoscopy unit at the San Raffaele hospital in Milan, space was also given to advice and suggestions relating to diet for adult patients with Crohn’s disease. Among the topics addressed, the effectiveness of the exclusion diet (Cded) integrated with Modulen – food for special medical purposes by Nestlé Health Science for those with Crohn’s disease.
“It is essential – said Ambra Ciliberto, dietitian of the Gastroenterology and digestive endoscopy Unit of the Irccs hospital of the San Raffaele hospital – that patients are aware of the importance of the “exclusion diet”, which is based on avoiding foods that could cause an alteration of the microbiota and intestinal function. The efficacy of Cded is supported by strong clinical evidence in the pediatric and adult patient, both in the acute and chronic phases”. Furthermore, “recent studies – adds Ciliberto – have demonstrated how the use of oral nutritional supplements (Ons) with anti-inflammatory properties before surgery is essential in patient management.In fact, peri-operative nutrition has been shown to reduce post-operative complications and even cancel, in some cases, the need for intervention itself”.
To support doctors and dieticians – details the note – Nestlé Health Science has created an update platform on CDED, Modulifexpert. While, to help the patient, an App is available that simplifies diet management at home, Modulife. “In Crohn’s disease and in Mice, the role of nutrition is fundamental – underlined Danese -. Being able to manage nutritional deficiencies is a key aspect to allow the patient to face the pharmacological or surgical path in the best possible way. In the peri – surgery, then, it is very important that the patient does not arrive underweight. Adverse events in the peri-operative period, in fact, are often influenced by a nutritional deficiency: the nutritional status of a patient who has to undergo surgery must be optimal”.
“The exclusion diet is a diet designed for patients with Crohn’s disease that has been shown to be effective in inducing disease remission in a high percentage of patients – added Ciliberto -. It is a phased diet combined with partial enteral nutrition. Unlike the sole use of partial enteral nutrition, the CDed is a diet well tolerated by both adult and pediatric patients, above all because it is pleasant in terms of taste, allowing the introduction of ‘real’ food into the diet and not just the ‘integration”.
Also for Salvatore Leone, general manager of Amici Onlus, nutrition plays an “important role in the management of Crohn’s disease and ulcerative colitis, since these conditions can cause weight loss, malnutrition, diarrhea and other gastrointestinal problems that can negatively affect the quality of life of patients”. To improve nutrition in these people, “it is important that they follow a balanced diet adapted to their individual needs – remarked Leone – which can vary according to the severity of the disease and the response to treatment. Some patients may need to use foods for special medical purposes to supplement deficiencies. Furthermore, it is important that they are followed by their gastroenterologist and a dietitian or nutritionist to develop a personalized meal plan. Unfortunately, there is a gap in access to nutritional therapy and this is a common problem in many areas of our country”.
In some regions, “a dietician specialized in nutrition may not be available for patients with IBS, or patients may not be financially able to afford the purchase of medical foods for special purposes. It is important that institutions, patient associations and the scientific community work to ensure that all patients have access to adequate and personalized nutritional treatment, regardless of their financial situation or geographical residence”, he concludes.