Key Nutrients in the Management of Gastro-intestinal Diseases

Dietary therapy is an essential aspect of the management of gastrointestinal (GI) diseases. However, no single diet is likely to be effective for every patient. To best fulfil the need of each patient, it is thus important to understand the role of each key nutrient in the management of GI diseases. Care should also be taken to provide nutrients to optimise the intestinal microflora.

Dietary rest.
Traditionally, patients with vomiting and/or diarrhoea have been managed with dietary rest followed with small amounts of highly digestible “bland” diets. However, recent evidence suggests that enteral nutrition, early in the management of viral gastroenteritis, would be more effective than food deprivation.

Protein.
Protein digestibility
Patients with GI diseases should be fed diets with highly digestible (> 90 % digestibility) proteins. Undigested protein will over-stimulate the GI immune system and therefore increase the risk of inducing food allergy. Most patients with GI disease are even at higher risk as their mucosal barrier is damaged. Undigested proteins will also promote bacteria (i.e. Clostridium perfringens) that are believed to be harmful to the health of the colon and the host. Finally, putrefaction products (e.g. bioamines, mercaptans, indols, ...) resulting from the fermentation of undigested proteins in the colon will induce poor digestive tolerance, strong faecal odour and might result in inflammation, toxin production as well as hypersensitivity reaction.

Traditionally, animal protein sources have been considered as more digestible than vegetable protein sources. This is no longer true. Soy isolate, soy hydrolysate, corn gluten and wheat gluten are all purified sources of very highly digestible vegetable proteins.  [...]