Column of Dr. Pomeranian: diet and intestinal health

There is plenty of information on nutrition issues in all media. It is not easy for a medical layman to find out what is useful or even harmful. There is no shortage of half-truths and delusions. All micro- and macronutrients are indeed present in a healthy diet. Therefore, in nutritional medicine, there is no doubt from studies that the prophylactic use of dietary supplements in healthy people offers no benefit. Another situation is when people have chronic inflammatory bowel disease or liver disease.

People with celiac disease also need iron, vitamin D, B12, K, folic acid and, for example, micronutrients that can be prescribed by a doctor. A particularly difficult problem is the distinction between food intolerance and food allergy. These occur in about two to eight percent of Germany. They can be clearly demonstrated by special tests, because they are immune-mediated. Proof is possible with step-by-step diagnostics. About 25 to 30 percent of the population suffers from intolerance. In these cases, careful documentation (food diary) of the patient’s food intake is often very helpful. A special “widespread disease” is the so-called irritable bowel syndrome, which affects about eleven percent of people worldwide.

Some patients with irritable bowel syndrome (IBS) suffer from constipation problems, while others struggle with diarrhea-like symptoms. In recent years, the subject of scientific discussion is the connection with bacterial colonization of the intestine (microbiome), but also the intestinal-brain axis. The treatment is performed in addition to nutritional therapy in the sense of microbiotherapy or drug therapy. In some cases, psychotherapy is necessary. The research intensively deals with the question of whether the microbiome plays a significant role in the onset and progression of inflammatory bowel diseases (ulcerative colitis, Crohn’s disease). This is a completely new therapeutic approach, so far attempts have been made to treat inflammation in the intestines with anti-inflammatory drugs and so-called immunosuppressants.

The importance of a high-fiber diet has been reaffirmed. The recommended dose is 30 grams per day. This value is not reached in most cases (18 to 19 grams / day). This requires a sufficient liquid supply of about 1.5 liters. With this diet, there are detectable effects on the development of cardiovascular diseases, but also on high blood pressure, type 2 diabetes and the development of intestinal cancer. The diet should include vegetables, fruits, legumes, nuts and whole grains.

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