P1203Evaluation of a low-fibre diet in patients with active Ulcerative Colitis: A prospective cohort study

Abstract Background Ulcerative Colitis (UC) is an inflammatory bowel disease (IBD) that affects the mucosa of the colon and rectum. Dietary fibre (DF) has been reported to play a key role in disease remission and nutritional status (1, 2). During remission periods, when the disease is not active, DF has been associated with gastrointestinal health benefits, reducing the likelihood of triggering a new active flare (3). Conversely, during active periods, there are no specific dietary guidelines regarding DF intake, and few studies have directly examined the impact of a low-fibre diet (LFD) on gastrointestinal symptom modulation in patients with active UC (4). Therefore, the aim of this study was to evaluate the association between a low-fibre diet and clinical disease activity in UC, as well as its impact on nutritional status. Methods A prospective cohort study was conducted in patients with active UC treated at the IBD Clinic of the Hospital General de México. Participants were classified into two groups according to their DF intake, assessed through food frequency questionnaires and 24-hour dietary recalls: low-fibre diet (LFD) and standard diet (SD) (Table 1). Anthropometric, biochemical, and clinical parameters were evaluated, including disease activity. Follow-up lasted 10 weeks and Student’s t-tests, Mann–Whitney U tests, and χ² tests were used (p 0.05). Results A total of 34 adult patients were included (37±11 years). The LFD group showed a significant reduction in diarrhoeal episodes (from 11 to 5; p = 0.04) and a trend towards lower disease activity (Table 2). In the SD group, anthropometric improvements and a more favourable metabolic profile were observed, while HDL levels increased in the LFD group (p = 0.036). Both groups showed a clear trend towards reduced clinical activity. Conclusion A low-fibre diet during active UC flares may help reduce gastrointestinal symptoms, particularly diarrhoea, and support clinical improvement. However, prolonged implementation reduces the intake of essential nutrients, which may compromise nutritional status. Its use is recommended only during the active phase of the disease, along with appropriate supplementation. Further studies are required to establish clear dietary guidelines for active UC. References: 1. Vieujean S, Lindsay JO, D’Amico F, Ahuja V, Silverberg MS, Sood A, et al. Analysis of clinical trial screen failures in inflammatory bowel diseases: real world results from the International Organization for the Study of IBD. J Crohns Colitis. 2023. 2. Suskind DL, Lee D, Kim YM, Wahbeh G, Singh N, Braly K, et al. The specific carbohydrate diet and diet modification as induction therapy for pediatric Crohn’s disease: a randomized diet-controlled trial. Nutrients. 2020;12(12). 3. Ferenc K, Jarmakiewicz-Czaja S, Filip R. Components of the fiber diet in the prevention and treatment of IBD: an update. Nutrients. 2022;15(1):162. doi:10.3390/nu15010162. 4. Wong C, Harris PJ, Ferguson LR. Potential benefits of dietary fibre intervention in inflammatory bowel disease. Int J Mol Sci. 2016;17(6). Conflict of interest: Mr. Baños Vazquez, Roberto: No conflict of interest Santoyo Chávez, Martha Alison: No conflict of interest Mendoza Martinez, Viridiana Montsserrat: No conflict of interest Rivera, Ernestina: No conflict of interest De Leon Rendon, Jorge Luis: No conflict of interest Abarca Rojano, Edgar: No conflict of interest Carrillo Rojas, Javier Ivanovychs: No conflict of interest Varela Martinez, Yessica Nohemí: No conflict of interest Bueno Hernández, Nallely: No conflict of interest