Impact of Diet on Inflammatory Bowel Disease Symptoms: An Adolescent Viewpoint

Background: Dietary modification shows promise as therapy in inflammatory bowel disease (IBD); however, it is unknown whether adolescents are interested in a dietary approach. Methods: Cross-sectional survey of adolescents with IBD ages 14-21 on disease knowledge, dietary habits, and perceptions of diet therapy. Results: A total of 132 subjects (48.5% female), mean age of 17.8 years and median disease length of 5 years (range 0, 16), completed the survey. Diet was perceived as a symptom trigger by 59.8% of subjects, and 45.4% had tried using diet as a treatment for symptom resolution, often without physician supervision and with limited success. Subjects experiencing active disease symptoms as determined by Manitoba IBD Index were more likely to be currently modifying their diet compared to subjects without active disease symptoms (odds ratio = 4.11, confidence interval = 1.58, 10.73, P = 0.003). Conclusions: Adolescents with IBD perceive a relationship between diet and disease symptoms and are interested in dietary modification as a symptom management option. Lay Summary Increasing evidence links diet to inflammatory bowel disease (IBD) symptoms and disease exacerbations. Dietary modification is being explored as a disease management method and studies indicate that dietary modification may be effective for children with IBD. In this study, 132 adolescent IBD patients (14-21 years old) were surveyed about their disease symptoms, diet, and thoughts about modifying their diet to control symptoms. Over half of the subjects stated specific foods or food categories made their symptoms worse. Of these subjects, just less than half tried changing their diet to control their disease. A majority of subjects found dietary modification challenging, primarily because they could no longer eat favorite foods. The most common reason for discontinuing dietary modification was a lack of symptom improvement. However, the subjects that reported using diet modification tended to have more active disease symptoms and many were attempting diet modification without the assistance of their doctor or dietitian. These results show that many adolescents with IBD believe diet changes disease symptoms and are likely to self-modify their diet to try to manage their disease. Adolescent IBD patients may have better success with dietary modification strategies with assistance from medical professionals using electronic educational platforms.