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Modulen Ibd Latte Polvere 400g

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Sarbagili Shabat C, Scaldaferri F. Use of faecal transplantation with a novel diet for mild to moderate active ulcerative colitis: The CRAFT UC Randomised Controlled Trial. J Crohns Colitis. 2022 Mar 14;16(3):369-378. Sarbagili Shabat C, Scaldaferri F. A Novel UC exclusion diet and antibiotics for treatment of mild to moderate pediatric ulcerative colitis: A prospective open-label pilot study. Nutrients. 2021 Nov; 13(11): 3736.

of Gastroenterology and Hepatology, Chinese People's Liberation Army General Hospital, Beijing, China Group 2 received FT as above but with dietary preconditioning of the donor for 14 days and a UCED for the patients. Vasseur P, et al. Dietary Patterns, Ultra-processed food, and the risk of inflammatory bowel diseases in the NutriNet-Santé cohort. Inflamm Bowel Dis. 2021 Jan 1;27(1):65-73. Yanai et al., The Crohn’s disease exclusion diet for induction and maintenance of remission in adults with mild-to- moderate Crohn’s disease (CDED-AD): an open-label, pilot, randomized trial. Lancet Gastroenterol Hepatol. 2022;7:49-59.Finally, in addition to gut integrity, Modulen ® elements will likely benefit other organs and physiological processes allowing a well-being stage. Naturally, physical ameliorations go along with mental ones, thus achieving an effective quality of life. Clinical studies using Modulen IBD® as PEN show that CDED + PEN was as effective as the current EEN standard in achieving remission, but the CDED + PEN was better tolerated and superior for sustaining remission. CDED is now the best documented effective dietary therapy (besides EEN) in inducing remission in CD. There is increasingly new data on CDED use in adults and those with more severe CD. The next step is to look for new indications for using CDED, including in combination with other therapies, and exploring new ways to improve CDED success for pediatric IBD patients. Practical cases of using CDED in adult patients

M Szczubełek, Pomorska K, et al. Effectiveness of Crohn’s Disease Exclusion Diet for induction of remission in Crohn’s disease adult patients. Nutrients. 2021 Nov 17;13(11):4112. The return of symptoms during the maintenance phase can pose a challenge; however, this can often be related to the level of patient compliance and can be managed by a careful dietetic follow-up. Anti-TNF treatment is not all-encompassing despite its vital role in IBD treatment. Up to 40% of patients do not respond to TNF inhibitors, and nearly 23–46% of patients experience secondary loss-of-response 1 year after anti-TNF-α treatment ( 6). It may be possible to achieve long-term remission through dose escalation, shorter intervals between infusions ( 78) or combination therapy ( 79). Due to anti-TNF agents' dose-related therapeutic benefit, measurement of serum trough level and anti-drug antibody is advocated ( 80, 81). Anti-IL-12/23 Therapy A patient with an ileostomy was referred for CDED postoperatively to reduce his risk of postoperative recurrence as he was at risk of short bowel syndrome if he required further surgery and had failed multiple drug therapies.Patient selection for CDED is important. For complex fistulating disease, EEN would still be the first line, but CDED can be considered if the patient is stable enough without the presence of abscesses, usually after an initial period of EEN. If a patient presents with tight inflammatory strictures or a bowel obstruction, EEN would also be considered as the first line. However, with small adaptions, CDED can still be used once inflammation reduces. Modulen ® is different from other EN formulas mainly by its TGF-β2 amount ( Figure 1 right panel) [ 32]. This cytokine has intestinal benefits such as promoting IgA production, regulating tight junction proteins, and preventing Goblet cell depletion [ 41]. Furthermore, stimulating intestinal cells with TGF-β2 has down-regulated CXCL-8, IL-6, and TNFα ( Figure 1, right panel) [ 42]. This lessening concerns both macrophage cytokines [ 42] and transcriptional level modifications [ 42, 43]. Moreover, depleting TGF-β signalling emphasizes weight loss and inflammation in a mouse model of colitis [ 43]. Other studies have shown the ability of TGF-β2 to prevent necrotizing enterocolitis [ 44] and mucositis [ 45]. Knowing that TGF-β is also involved during restitution of mucosal healing [ 41], remission outcomes obtained with Modulen ® could be principally explained by this cytokine ( Figure 1, right panel). However, other components may play a potential role and should not be excluded. This is the case of protein and fatty acid contents that deserve interest. None of the therapies were effective for the most severe patients (SCCAI >9). Only one out of 28 biologic refractory patients achieved clinical remission. Racine A, et al. Dietary patterns and risk of inflammatory bowel disease in Europe: Results from the EPIC Study. Inflamm Bowel Dis. 2016 Feb;22(2):345-54. At present, pharmacological intervention is important for IBD treatment. The medications mainly include aminosalicylates, CSs, immunomodulators, biologics, and oral small molecules. We mainly introduced their mechanism of action, efficacy, and safety in UC or CD. Aminosalicylates

MRI showed 5–10 cm patchy ileocecal inflammation (ICV). Colonoscopy showed deep ulcers in ICV. The patient had previously demonstrated loss of response to infliximab, adalimumab and azathioprine, and was being treated with ustekinumab weekly. Consumption of dietary fibre was associated with reduced disease flares in patients with CD but not UC. 77 Recommendations to limit dietary fibre, as proposed in the low-residue diet often prescribed in patients with diarrhoea to enhance digestive comfort should be re-evaluated. The next stage was to investigate whether CDED can be used to treat adults with CD, patients with severe luminal CD, therapy for longer than 12 weeks and for patients refractory to biologics and/or as an adjuvant therapy to biologics. The diet emphasizes components that offer a protective effect, including fruit and vegetable fibers, pectin and resistant starch, and tryptophan. UCED has some important distinctions from the CDED: Mechanisms of action of Modulen ® on intestinal epithelium. The left panel represents the consequences of a liquid, exclusive, and fibers/lactose/gluten-free diet, as well as TGF(transforming growth factor-beta) MCT (medium-chain triglycerides), palmitic acid, α-linolenic acid, and 15-HETE (15-hydroxyeicosatetraenoic acid);. The right panel focuses on leucine, caprylic, glutamic and palmitic acid, MCT, TGF-β, and β-casofensin.The principles of UCED are to reduce or exclude certain dietary components that have been shown to have a negative effect on the microbiome–host interaction through several mechanisms: barrier function, mucosal immunity, colonic metabolites, and energy homeostasis. These include sulfated amino acids, dietary sulfur, processed foods, animal protein and saturated fat. One of the most studied exclusion diets for the treatment of IBD is the Specific Carbohydrate Diet (SCD). Initially, it was developed for the treatment of coeliac disease, 48 but it became very popular in IBD due to several impressive lay reports indicating the potential to treat various diseases, including UC. The principle of the SCD is to remove grains including wheat, barley, corn, and rice; added sugar is limited to honey and also most milk products are restricted except for fully fermented yogurts. The rationale of the SCD is based on the notion that polysaccharides and complex sugars are poorly absorbed in the intestinal tract causing potentially bacterial (and possibly fungal) overgrowth with subsequent inflammation of the intestinal and colonic mucosa. Suskind and colleagues reported clinical remission in seven children with CD after a SCD diet of several months (average 14.6±10.8months) with a significant improvement of inflammatory markers. 49 An additional retrospective study of the same group 50 confirmed in 20 children with CD and 6 children with UC a marked reduction in disease activity scores under SCD, in line with the observation of 50 adult patients with IBD responding favourably to prolonged SCD. These data were obtained by a patient reported 3-day dietary survey. 51 Cohen and colleagues 52 reported that 8 of 10 children/adolescents with CD responded to a 12-week cycle with SCD; 1 was not able to take the diet, while 1 patient with colonic CD experienced a relapse. In the following study, seven patients continued the diet for 52weeks. Since these first observations, several studies have been performed, analysing the potential of SCD to control inflammation in children and adults with IBD. Suskind and colleagues 53 showed, in a prospective study on 12 children with mild to moderate IBD (CD and UC), that the addition of SCD over a 12-week period to ongoing medication allowed remission to be reached in 8 of 12 patients; 2 patients did not respond to SCD and two patients were not able to maintain the diet. Microbial analyses of these patients confirmed a marked difference between baseline and after 12weeks of SCD. Additional retrospective, studies on CD and UC, including one online survey, confirmed the perception of a clinical benefit and the potential of SCD to reduce inflammation and its efficacy inducing and maintaining remission over several months. 50, 54, 55 While weight loss is a concern when utilizing SCD, many academic IBD centres have developed active dietary programs supporting patients on SCD. 50, 51, 56 In the study of Cohen and colleagues, 52 repeat endoscopic evaluations were available, indicating the potential of SCD to induce mucosal healing, as shown for two patients and also in the report by Miller and colleagues. 57 Another study 58 failed to demonstrate achieving mucosal healing despite a positive clinical evolution in patients on a modified SCD (integrating some initially excluded foods, such as potatoes, rice, quinoa or oats). Since adherence to SCD, as to other exclusion diets, can be a challenge and modification of SCD might compromise the clinical anti-inflammatory effects, well-designed and precise prospective randomized trials are needed to further affirm this promising treatment option. A second study looked at the effect of UCED in pediatric patients with mild-to-moderate active disease. 29 Patients were introduced to UCED for the first 6 weeks, and those in remission at week 6 received a step-down diet for another 6 weeks.

Contains Transforming Growth Factor –ß2 (TGF-ß2) from patented manufacturing process. TGF-ß2 has natural anti-inflammatory properties to reduce inflammation associated with inflammatory bowel disease The therapeutic efficacy of aminosalicylic acid preparations for CD remains controversial. A review has suggested that oral 5-ASA preparations have no significant advantage in maintaining remission in patients with CD ( 17). However, a retrospective study in the UK found that 5-ASA was widely used as a long-term treatment for CD as about a quarter of patients continued to use 5-ASA for more than 10 years ( 18). 5-ASA therapy for more than a year could reduce the consumption of related medical resources (including referrals, hospitalization, and surgery) ( 18). Gjuladin-Hellon et al. have reported the benefit of 5-ASA in preventing relapse of CD in remission after surgery ( 19). Coward et al. in their Bayesian network meta-analysis found that high-dose mesalamine is an option for inducing remission among mild-to-moderate CD patients preferring to avoid steroids ( 20). Other studies have also reported the treatment effectiveness of aminosalicylates in CD ( 21, 22). Khalili, et al. Identification and characterization of a novel association between dietary potassium and risk of Crohn's disease and ulcerative colitis. Front Immunol. 2016 Dec 7;7:554. Registered Dietitian & Researcher, Wolfson Medical Center, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel Diet may also have an impact on the mucosal layer of the digestive tract. Recent studies have demonstrated that microbiota can influence the properties of the colonic mucus layer. 23 Some bacteria possess various enzymes allowing them to degrade and metabolize specific glycans of the intestinal mucosal layer. Desai and colleagues 24 demonstrated that low-fibre diet promotes expansion and activity of colonic mucus-degrading bacteria and that fibre-deprived gut microbiota promote aggressive colitis by an enteric pathogen.Meets the RDI for adult patients in 2000ml per day; for children the RDI is met per volume appropriate for age Following this study, a number of reports confirmed the effectiveness of CDED+PEN in practice, making CDED a well-recognized and important alternative to EEN. Nikolaus S, Schreiber S. Diagnostics of inflammatory bowel disease. Gastroenterology. 2007 Nov; 133(5):1670-89. Multiple studies have suggested that IL-12/23 and IL-23 antagonists are potential therapeutic options for IBD treatment. Experts recommended IL-12/23 and IL-23 antagonists as a first- or second-line therapy because of their efficacy in biologic-naïve and experienced patients ( 90). Anti-integrin Therapy

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