Abstract The incidence of inflammatory bowel disease (IBD) is increasing globally, and dietary avoidance due to fear of aggravating gastrointestinal symptoms has become a common clinical issue. A considerable proportion of IBD patients develop persistent restrictive eating behaviors, which may further progress to avoidant/restrictive food intake disorder (ARFID). ARFID seriously impairs nutritional status, quality of life, and psychosocial function in affected individuals and has gradually attracted clinical attention. This narrative review summarizes the definition, epidemiological characteristics, pathogenesis, influencing factors, and intervention strategies of ARFID in patients with IBD. Current evidence indicates that ARFID is highly prevalent in the IBD population, with a wide range of prevalence estimates due to inconsistent assessment tools. The pathogenesis mainly involves abnormal fear‑related neural regulation and dysregulation of the microbiota‑gut‑brain axis. Major risk factors include active disease, anxiety and depression, and insufficient food literacy. Although dietary interventions, cognitive behavioral therapy, nutritional education, and multidisciplinary management have shown potential benefits, high‑quality evidence remains limited, and IBD‑specific screening tools and standardized intervention protocols are still lacking. Future research should focus on developing validated ARFID screening instruments for IBD patients and conducting high‑quality clinical trials to verify the efficacy of targeted interventions. Routine screening and early intervention of ARFID should be integrated into the clinical management of IBD to improve long‑term prognosis.
Wu et al. (Fri,) studied this question.
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