الفهرس 
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Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract, which clinically contains Crohn’s disease, ulcerative colitis, and other conditions. The inflammation of the intestinal mucosa in IBD is characterized by episodes of abdominal pain, diarrhea, bloody stools, weight loss, and the influx of neutrophils and macrophages that produce cytokines, proteolytic enzymes, and free radicals that result in inflammation and ulceration.
The worldwide rising incidence of IBD is paralleled by a “Westernization” of dietary habits in developing countries. It is therefore obvious that, in addition to a genetic influence, environmental factors, especially diet, undoubtedly play a major role in the development of IBD.
The exact pathomechanism how diet promotes the development of IBD is still unknown, while 2 main mechanistic explanations are most prominent and need to be pointed out. First of all, diet has a profound impact on the composition of gut microbiota and changes of nutritional composition during early childhood or even later in life can favor an anti- or proinflammatory composition.
The aims of our study is to assess the nutrient status of individuals with CD and UC in relation to the recommended nutrient intake values, anthropometric measures, and biochemical indices of nutrition, and to determine the extent to which reduced food and nutrient intake contributes to the nutrition deficiencies in this population.
This was across-sectional study was conducted on patients with IBD, including Crohn´s disease (CD), ulcerative colitis (UC)and undtermined colitis, who attended to the outpatient clinic for IBD of the Department of Internal Medicine, University Hospital of Ain Shams University, between january 2020 to july 2020. 90 patients with IBD (65 UC patients, 22 CD patients and 3 UD colitis) were included in the study.
Our study show that The majority of our IBD patients showed a normal BMI indicating that malnutrition, especially underweight, is not as common a described in former studies with up to 85% in IBD patients.
Whereas the prevalence of malnutrition and underweight has decreased over the past years [30], patients with IBD are more often overweight or obese now, probably as a result of improved therapeutic options and prolonged remission status.
Our study show that majority of patients are suffering from GI upset following certain meals, all of them are suffering from flatulance, some of them suffering from nausea, vomiting, heart burn and 79(87.7%) patients are suffering from diarrhea, most of patients with crohns disease are suffering from constipation, and some of them are suffering from intestinal colick. So Many patients with IBD suppose that the diet influences the courseof their disease or even cause a relapse
Therefore, patients often start dietary changes and avoid “trigger foods” which might worsen their symptoms. In our study, 23% of the IBD patients claimed to have changed their diet, mostly because of gastrointestinal afflictions including indigestions, bowel complaints or stomach pain.
There is no significant avoidace of fruits and in our study that did not match with another studies like which stated that there is a high restriction rate in their IBD patients that may be explained by small sample size.
Our study reported the avoidance of milk and dairy products is upto 32% and the restriction about 22% to 40% which is relatively less in comparison with other studies that reported the avoidance of milk and dairy products in up to 65% of patients with IBD.
Furthermore, our study groups showed an unfavorable ratio of essential fatty acids (FA) compared to the recent guidelines. Whereas the ratio of the n-6 fatty acid linolic acid (LA) to the n-3 fatty acid α-linolenic acid (ALA) should be 5:1, the actual ratio was more than in all participants because of the high incidence of margarine ingestion.
Also our study show that most our BID patient have minerals deficiency like Na, K, Mg and Ca. and the Cause of this micronutrient deficiencies are multifactorial and include a restricted food intake, enteric loss of vitamins, malabsorption, and undesirable effects of some medication.
According to food cosumption most of our IBD patients have acceptable food consumtion according to FCS, this discripancy may be from the short period of recall as it only 7 days recall and also caloric intake.