IBD IBD Nutrition and Lifestyle 1 — Questions and Answers
Question 1: Exclusive enteral nutrition (EEN) in pediatric Crohn's disease is considered equivalent to which treatment for inducing remission?
- Biologics
- Corticosteroids (Correct answer)
- Antibiotics
- Azathioprine
Correct answer: Corticosteroids
In pediatric Crohn's disease, EEN achieves remission rates comparable to corticosteroids while promoting linear growth and mucosal healing without steroid side effects.
Question 2: Which dietary pattern has the most evidence for reducing IBD flare risk in clinical studies?
- Carnivore diet (animal products only)
- Mediterranean diet (high fiber, omega-3s, fruits, vegetables, olive oil) (Correct answer)
- Low FODMAP diet as primary IBD therapy
- Gluten-free diet without celiac disease
Correct answer: Mediterranean diet (high fiber, omega-3s, fruits, vegetables, olive oil)
Mediterranean diet patterns are associated with reduced IBD flare risk and inflammatory markers through anti-inflammatory omega-3s, polyphenols, and prebiotic fiber.
Question 3: The low FODMAP diet is most appropriately used in IBD to manage which condition?
- Active mucosal inflammation
- Concurrent irritable bowel syndrome (IBS)-like symptoms in IBD remission (Correct answer)
- Nutritional deficiencies from malabsorption
- Corticosteroid-induced hyperglycemia
Correct answer: Concurrent irritable bowel syndrome (IBS)-like symptoms in IBD remission
Low FODMAP reduces fermentable carbohydrates that cause IBS-like functional symptoms (bloating, gas, pain) in IBD patients who are in endoscopic remission but have persistent GI symptoms.
Question 4: Vitamin D deficiency in IBD patients is clinically significant because vitamin D plays which role beyond bone health?
- It has immunomodulatory effects, and deficiency is associated with increased IBD disease activity and flare risk (Correct answer)
- It prevents anemia of chronic disease
- It directly inhibits TNF-α production
- It enhances mesalamine absorption
Correct answer: It has immunomodulatory effects, and deficiency is associated with increased IBD disease activity and flare risk
Vitamin D modulates innate and adaptive immunity, and deficiency is associated with increased IBD disease activity; supplementation may reduce relapse risk in deficient patients.
Question 5: Which micronutrient deficiency is most common in patients with Crohn's disease affecting the terminal ileum?
- Vitamin C
- Vitamin B12 (cobalamin) (Correct answer)
- Niacin
- Riboflavin
Correct answer: Vitamin B12 (cobalamin)
Terminal ileal Crohn's disease impairs intrinsic factor-mediated vitamin B12 absorption, requiring intramuscular or high-dose oral B12 supplementation.
Question 6: Parenteral nutrition (PN) in IBD is used primarily for which indication?
- Routine supplementation during mild flares
- Severe malnutrition, high-output fistulas, or short bowel syndrome where enteral feeding is not tolerated (Correct answer)
- Weight management in obese IBD patients
- Pre-biologic optimization in all patients
Correct answer: Severe malnutrition, high-output fistulas, or short bowel syndrome where enteral feeding is not tolerated
PN is reserved for severe cases where the gut cannot be used — high-output fistulas, SBS-related enteral intolerance, or severe malnutrition requiring bowel rest.
IBD IBD Nutrition and Lifestyle 1
Exclusive enteral nutrition (EEN) in pediatric Crohn's disease is considered equivalent to which treatment for inducing remission?