Historically, dietitians played a minor part in the management of inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. Patients were commonly referred for consequences of uncontrolled disease, such as malnutrition and bowel obstruction risk. Today, dietitians are fundamental members of the multidisciplinary IBD team, from educating on the role of diet at diagnosis and throughout the lifespan of a patient with IBD to guiding primary induction therapy. This aspect is reflected in published guidelines for IBD management, which previously placed diet as only a minor factor, but now have diet-specific publications. This Review describes a four-step approach in a dietitian’s assessment and management of diet in patients with IBD: (1) identifying and correcting nutritional gaps and dietary imbalances; (2) considering diet to treat active disease with the use of exclusive enteral nutrition (EEN) or emerging diets that could replace EEN; (3) using therapeutic diets to control existing complications of IBD, such as reduced fibre to prevent bowel obstruction in stricturing disease or a fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet to manage co-existing functional gut symptoms; and (4) considering the role of diet in preventing IBD development in high-risk populations.

从历史上看，营养师在炎症性肠病 (IBD) 的管理中发挥了很小的作用，包括克罗恩病和溃疡性结肠炎。患者通常因未控制疾病的后果而被转诊，例如营养不良和肠梗阻风险。今天，营养师是多学科 IBD 团队的基本成员，从教育饮食在 IBD 患者诊断和整个生命周期中的作用到指导初步诱导治疗。这方面反映在已发表的 IBD 管理指南中，该指南以前仅将饮食视为次要因素，但现在有针对饮食的出版物。本综述描述了营养师评估和管理 IBD 患者饮食的四步方法：（1）识别和纠正营养缺口和饮食失衡；(2) 考虑使用独家肠内营养 (EEN) 或可以替代 EEN 的新兴饮食来治疗活动性疾病的饮食；(3) 使用治疗性饮食来控制现有的 IBD 并发症，例如减少纤维以预防狭窄性疾病中的肠梗阻，或使用可发酵的低聚糖、二糖、单糖和多元醇饮食来控制共存的功能性肠道症状；(4) 考虑饮食在预防高危人群 IBD 发展中的作用。单糖和多元醇饮食以控制共存的功能性肠道症状；(4) 考虑饮食在预防高危人群 IBD 发展中的作用。单糖和多元醇饮食以控制共存的功能性肠道症状；(4) 考虑饮食在预防高危人群 IBD 发展中的作用。