Болезнь Крона и питание: современные взгляды на диетотерапию и нутритивную поддержку

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.

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