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Nutritional Management in IBD: From Malnutrition Diagnosis to Targeted Therapy

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 25 June 2026 | Viewed by 1941

Special Issue Editor


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Guest Editor
Gastroenterology Department, Monsignor Raffaele Dimiccoli Hospital, Barletta, Italy
Interests: Crohn's disease; ulcerative colitis; malnutrition; complications of malnutrition; morbidity; mortality; oral supplementation; enteral nutrition; parenteral nutrition; and short bowel syndrome

Special Issue Information

Dear Colleagues,

Introduction: Protein–energy malnutrition affects approximately 75% of patients with active Inflammatory Bowel Disease (IBD), particularly those with Crohn's disease. Unfortunately, nutritional improvement is often overlooked as a therapeutic objective in IBD management. Furthermore, clinical practice presents diverse IBD patient populations, including the following: a) well-nourished patients with quiescent disease; b) well-nourished patients with mild-to-moderate disease; c) well-nourished patients with severe diarrhea and high intestinal losses; d) well-nourished patients with intestinal strictures and symptoms of intestinal obstruction; and e) malnourished patients or those at risk of malnutrition. Each of these populations requires tailored dietary management.

Aims: The purpose of this Special Issue is to emphasize the following points: i) at the time of IBD diagnosis, patients should undergo immediate nutritional screening using GLIM criteria as specific monitoring parameters; ii) personalized nutritional therapy must be included among the therapeutic objectives of a treat-to-target approach for all IBD patient types.

Scope: STRIDE II should be updated to incorporate nutritional optimization as an essential target.
Key Topics of Interest: Topics of interest include nutritional evaluation, the diagnosis of malnutrition, nutritional treatment, dietary advice, oral supplementation, and artificial nutrition.

Dr. Francesco William Guglielmi
Guest Editor

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Keywords

  • Crohn’s disease
  • ulcerative colitis
  • malnutrition
  • malnutrition complications
  • morbidity
  • mortality
  • oral supplementation
  • enteral nutrition
  • parenteral nutrition
  • short bowel syndrome

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Published Papers (2 papers)

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Research

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17 pages, 12209 KB  
Article
Sodium Butyrate Alleviates IBD by Modulating SIRT1-Involved Ferroptosis and Inhibition of Macrophage Ferroptosis
by Nachuan Chen, Shaofeng Luo, Xin Zhou, Boren Zhu, Yingyin Liu, Huaxing He, Shunli Luo and Suxia Sun
Nutrients 2026, 18(4), 598; https://doi.org/10.3390/nu18040598 - 11 Feb 2026
Cited by 1 | Viewed by 714
Abstract
Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), severely affects patients’ quality of life. Sodium butyrate (NaB) has been reported to improve IBD manifestations, although its underlying mechanisms remain incompletely understood. Methods: An IBD mouse model was [...] Read more.
Background: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), severely affects patients’ quality of life. Sodium butyrate (NaB) has been reported to improve IBD manifestations, although its underlying mechanisms remain incompletely understood. Methods: An IBD mouse model was induced with 3% (w/v) dextran sulfate sodium (DSS). Mice were administered NaB (500 mg/kg, gavage), 5-aminosalicylic acid (5-ASA,150 mg/kg, gavage), or the ferroptosis inhibitor ferrostatin-1 (Fer-1, intraperitoneal injection). Western blotting (WB) and real-time quantitative PCR (RT-qPCR) were performed to evaluate ferroptosis-related molecules and target pathway components. Immunofluorescence staining was used to assess ferroptosis in macrophages preliminarily. Results: NaB alleviated clinical symptoms of IBD in mice, including mitigation of body weight loss, restoration of colon length, reduction in disease activity index (DAI), decreased spleen index, and protection of the intestinal barrier. In addition, compared with the DSS model group, NaB downregulated ACSL4 and upregulated GPX4 and SLC7A11, indicating an inhibitory effect on ferroptosis. WB results showed that SIRT1 expression was enhanced in the DSS + NaB group. In addition, immunofluorescence staining demonstrated that compared with the DSS group, GPX4 expression was increased in macrophages in the DSS + NaB group. Conclusions: NaB alleviates IBD by modulating SIRT1-associated signaling molecules and inhibiting ferroptosis, including inhibiting macrophage ferroptosis. Full article
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Review

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14 pages, 587 KB  
Review
Approach to Malnutrition and Oral Nutrition Therapy in Adults with IBD: What to Consider
by Jessica Sosio, Mark Zemanek and Lindsey Anne Russell
Nutrients 2026, 18(2), 204; https://doi.org/10.3390/nu18020204 - 8 Jan 2026
Viewed by 861
Abstract
Inflammatory Bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic gastrointestinal conditions that are prone to malnutrition due to poor oral intake, intestinal compromise of nutrient absorption, and increase in metabolic demand. Screening and diagnosing malnutrition in this population [...] Read more.
Inflammatory Bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic gastrointestinal conditions that are prone to malnutrition due to poor oral intake, intestinal compromise of nutrient absorption, and increase in metabolic demand. Screening and diagnosing malnutrition in this population is necessary to treat and prevent worsening malnutrition. The use of Oral Nutritional Therapy (ONS) can provide the macronutrients that patients need to maintain their nutrition, however their role in within stages of diseases, active disease, remission, perioperative, and maintenance in relation to other nutritional therapies, such as enteral nutrition or parenteral nutrition, is unclear. This review will highlight the principles of diagnosing malnutrition, the evidence of ONS in disease and remission states, and the role of oral vitamins in the management of IBD. Full article
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