medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-13-16-23medalphabet-4448Research ArticleСтатьиБолезнь Крона и питание: современные взгляды на диетотерапию и нутритивную поддержкуCrohn's disease and nutrition: current perspectives on dietary therapy and nutritional supporthttps://orcid.org/0000-0001-8402-0743ЩукинаО. Б.ShchukinaO. B.

Щукина Оксана Борисовна, врач-гастроэнтеролог, д.м.н, профессор кафедры общей врачебной практики (семейной медицины

Санкт-Петербург

Shchukina Oksana B., gastroenterologist, DM Sci (habil.), professor at Dept of General Medical Practice (Family Medicine)

Saint Petersburg

https://orcid.org/0009-0009-3695-5646СамолетоваВ. А.SamoletovaV. A.

Самолетова Вероника Алексеевна, врач-гастроэнтеролог

Санкт-Петербург

Samoletova Veronika A., gastroenterologist

Saint Petersburg

 

dr.samoletova@gmail.comhttps://orcid.org/0009-0003-2457-2863ИсаковаА. В.IsakovaA. V.

Исакова Антонина Владимировна, студентка VI курса лечебного факультета

Санкт-Петербург

Isakova Antonina V., 6th year student at General Medicine Faculty

Saint Petersburg

tonis2001@mail.ruФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава РоссииРоссияPavlov First State Medical University of St. Petersburg (Pavlov University)Russian FederationСПб ГБУЗ «Городской консультативно-диагностический центр № 1»РоссияCity Consultative and Diagnostic Center No. 1Russian Federation202524072025013Гастроэнтерология и диетология (2)1623Copyright © Щукина О.Б., Самолетова В.А., Исакова А.В., 20252025Щукина О.Б., Самолетова В.А., Исакова А.В.Shchukina O.B., Samoletova V.A., Isakova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4448

Болезнь Крона (БК) представляет собой хроническое воспалительное заболевание кишечника неустановленной этиологии, характеризующееся прогрессирующим течением и развитием осложнений, требующих хирургического вмешательства у большинства пациентов. В патогенезе болезни важную роль играет нарушение кишечной микробиоты, обусловленной влиянием факторов окружающей среды, среди которых ведущее значение имеет питание. Современные данные подтверждают негативное влияние ультрапереработанных продуктов на состав микробиоты и увеличение риска развития БК. В настоящей статье рассматриваются современные подходы к диетотерапии и нутритивной поддержке пациентов с БК, включая оценку нутритивного статуса, потребностей в макрои микронутриентах, а также коррекцию выявленных дефицитов. Особое внимание уделяется эффективности полного энтерального питания (ПЭП) и альтернативных диетических стратегий, таких как исключающая диета при болезни Крона (ИДБК) в сочетании с специализированным лечебным питанием, которые способствуют достижению ремиссии, заживлению слизистой оболочки и снижению воспалительной активности. В статье обсуждаются особенности диетотерапии в период ремиссии заболевания, а также нутритивная поддержка в преди послеоперационном периодах. Подчеркивается ключевая роль диетолога в мультидисциплинарной команде по ведению пациентов с БК и необходимость индивидуального подхода к диетотерапии с учетом культурных особенностей и пищевых предпочтений. На основании анализа современных данных делается вывод о важности включения нутритивной поддержки и диетотерапии в комплексное лечение БК, а также необходимости дальнейших исследований для оптимизации персонализированных диетических стратегий.

Crohn's disease (CD) is a chronic inflammatory bowel disease of unknown etiology, characterized by a progressive course and the development of complications that require surgical intervention in a significant proportion of patients. The pathogenesis of the disease involves a disruption of gut microbiota, influenced by environmental factors, with diet playing a key role. Current evidence confirms the negative impact of ultra-processed foods on microbiota composition and the increased risk of developing CD. This article reviews modern approaches to dietary therapy and nutritional support for patients with CD, including assessment of nutritional status, macroand micronutrient requirements, and correction of identified deficiencies. It evaluates the effectiveness of exclusive enteral nutrition (EEN) and alternative dietary approaches, such as the Crohn’s Disease Exclusion Diet (CDED), in combination with specialized enteral nutrition in achieving remission, promoting mucosal healing, and reducing inflammation. Additionally, it explores dietary strategies for maintaining remission and optimizing perioperative nutritional support. It emphasizes the key role of dietitians in the multidisciplinary team managing CD patients and the need for an individualized approach to dietary therapy, considering cultural preferences and food habits. Based on a review of current evidence, the article concludes that nutritional support and dietary therapy should be integral components of comprehensive CD treatment, while further research is needed to optimize personalized dietary strategies.

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The authors declare that there are no conflicts of interest present.