P554 Dietary practices and beliefs of patients with inactive ulcerative colitis: A prospective UK study

B. Crooks1, J. McLaughlin2, J.K. Limdi1

1Department of Gastroenterology, Northern Care Alliance, Manchester, UK, 2Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, UK

Background

Our understanding of the aetiopathogenesis of inflammatory bowel disease (IBD), in particular the impact of environmental factors, remains limited. The role of diet in IBD appears to be of particular importance to patients. The dietary habits of the IBD population with inactive disease have scarcely been reported. We describe the dietary practices of patients with inactive ulcerative colitis (UC) and the information resources which guide these beliefs.

Methods

We developed a questionnaire assessing demographics, dietary practices and the use of information resources in patients with inactive UC (defined as a PRO2 score ≤ 1 (rectal bleeding subscore = 0)). This is being prospectively administered to 200 consecutive patients with inactive UC.

Results

Data from 168 patients are available to date. Mean patient age is 54 years, 58% male and 89% Caucasian. Mean disease duration is 12 years. Disease extent is 20% E1, 43% E2 and 29% E3. Sixty-three per cent of patients report no relapse in the last year. 32% consider diet to be an initiating factor for their UC and this is based on their own experience (93%), the internet (30%) and a gastroenterologist’s advice (22%). 39% of patients feel that diet has previously triggered a relapse of their disease, the most commonly reported triggers being spicy foods (45%), alcohol (38%), fatty foods (38%), coffee (27%) and milk products (26%). Fifty-four per cent of patients avoid certain foods, at least sometimes, to prevent relapse. Spicy foods are most frequently avoided (76%) followed by fatty foods (65%), alcohol (53%), coffee (46%), carbonated drinks (44%), milk products (42%) and red meat (36%). Female patients are significantly more likely to restrict their diet in an attempt to prevent a relapse of their UC (p = 0.002). A fifth of patients consume specific foods or nutritional supplements to prevent a UC relapse, most commonly probiotics or turmeric. Fifty-seven per cent of patients believe that the recommended diet in disease remission is different to that in relapse however less than half of patients report being able to find specific dietary advice for UC. Dietary recommendations are most commonly sourced via the internet.

Conclusion

A significant proportion of patients with inactive UC have strong beliefs pertaining to diet and specific dietary triggers. Credible sources of dietary information for IBD patients remain lacking. A high prevalence of self-imposed dietary restriction may risk nutritional deficiency in such patients and impact upon the quality of life. More data and mechanistic explanations are needed to understand the complicated relationship between dietary components and gut inflammation. A larger dataset will be presented at conference proceedings.