專題報告 學生:謝璿 指導老師:翁慧玲營養師 報告日期:12/21

Report
Risk factors of Crohn’s Disease
報告者:謝璿
指導老師:翁慧玲營養師
報告日期:12/21
2
Ingested Matter Affects Intestinal
Lesions in Crohn’s Disease
Gregor Bartel, Ilse Weiss, Karl Turetschek,Wolfgang Schima, Andreas
Pu¨spo¨k,Thomas Waldhoer, and Christoph Gasche Inflamm Bowel Dis
2008;14:374 –382
Introduction

Environmental factors of the modern
Western life- style may trigger Crohn’s
disease in susceptible individuals.
Because such factors could be part of
ingested matter, they intended to
improve intestinal Crohn’s lesions by
exclusion thereof.
3
Methods
in the neoterminal
ileum in 2 cases
In the upper small bowel in the
remaining 3 cases
Judged by global physician
assessment
3 female, 2 male, median age
36, median duration of disease 7
years.
Patients
4
Located
5 pilot cases with CD
Ulceration
14 pt with mild-to-moderate CD
Primary:
Assesed by MRI
and endoscopy
of the leftsided colon or a
significant lesion of the
small bowel or right-sided
colon that was
assessable by means of
MRI.
Some patient will be
excluded.
Secondary:
Sonography, the CDAI
and the IBDQ
• 3 intramuscular multivitamin injections at
weeks 0, 3, and 6.
• Keep a nutrition and symptom diary
throughout the study.
• Contacted by the dietician.
Diedary Intervention
Active group
• Highly restricted diet
composed of red meat,
certain sourdough bread,
rape oil, and fresh butter
•Fruits and vegetables
were excluded
Control group
• Low-fat, high-carbohydrate diet
that is complete in nutrients, but to
avoid fiber-rich fruits and
vegetables
• Not to eat any red meat.
5
Result(Pilot Cases)
All patients showed significant
improvement of bowel symptoms within
4 to 6 weeks.
 Due to their individual success, 4
patients continued on a broadened
organic diet including fruits and
vegetables and were successfully
avoiding surgery during the following
years.

6
Result
7
Assesed by MRI
Result

Transabdominal bowel sonography(TABS)
showed improvement in 4 out of 5 patients in
the active and 1 out of 8 in the control group.

At the end of the follow-up period the TABS
scores further improved in 1 case and
worsened in 2 of the active group.

After 6 weeks the CDAI dropped in both
groups.
8
Discussion

Environmental factors with a Western
lifestyle might cause CD in genetically
susceptible individuals.

Complex nutritional changes, should be
able to improve or heal intestinal lesions in
CD.
9
Discussion

High drop-out rate.

Difficult to relate our results to previous
dietary studies in CD as they typically
focused on single dietary factors such as
sugar or fat and did not assess intestinal
healing as an endpoint.
10
Conclusions

Ingested matter as part of the modern
Western lifestyle may cause persistence
of intestinal Crohn’s lesions.
11
12
Dietary Patterns and Risk for Crohn’s
Disease in Children
Savio DS, Emile Levy, David Mack, David Israel, Philippe Lambrette and Parviz
Ghadirian. Inflamm Bowel Dis 2008;14:367–373
Introduction

Some dietary foods are considered
protective, whereas others are thought
to enhance the risk for Crohn’s disease
(CD). The evidence, however, is
inconsistent.
13
Methods
Newly diagnosed CD cases(< 20
years of age)
14
Controls were patients visiting the
orthopedic clinics and random-digit
dialing (RDD)
Using a validated food frequency
questionnaire(FFQ) and Youth
Adolescent Questionnaire (YAQ) .
Factor analyses and
unconditional logistic regression.
Result
15
16
15 patterns were
identified.were
4 patterns
were
and were retained.
16 patterns
identified,
ofinterpretable
which 4 patterns
retained .

Cronbach’s alphas:

Boys: 0.82, 0.65, 0.70, and 0.53 for
patterns partial western, prudent,
miscellaneous, and meat

Girls: 0.80, 0.60, 0.79, and 0.57 for
patterns western, prudent, cheesesnack, and beverages
17
Discussion
Dietary pattern studies have provided
valuable information on the
etiopathogenesis of diverse complex
diseases.
 Western pattern could confer risk for CD
among girls and that a prudent pattern
could protect both girls and boys from
acquiring CD.

18
Conclusions

Specific dietary patterns could be
associated with higher or lower risks for
CD in children.
19
20
Vitamin D-mediated calcium
absorption in patients
with clinically stable Crohn’s disease:
A pilot study
Meena K, Natasha B. Khazai, Thomas R. Ziegler, Mark S. Nanes
Steven A. Abrams and Vin Tangpricha Mol. Nutr. Food Res. 2010, 54, 1085–
1091
Introduction
Vitamin D is the critical hormone for
intestinal absorption of calcium.
 Crohn’s disease (CD), rheumatoid
arthritis (RA) and menopause are
examples of conditions associated with
increased fracture risk, impaired calcium
absorption and an increased
inflammatory state.

21
Methods
22
23
Result
24
Result
25
Conclusions

26
CD patients have a normal response to
vitamin D in enhancing the efficacy of calcium
absorption.
Summary

Western lifestyle and specific dietary
patterns could be increase the risks for
CD patient. We could use the dietary
patterns that, characterized by fruit,
vegetable and high amount of vitamin D
to avoid them.
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Thank you

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