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Modulen Ibd Latte Polvere 400g

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Modulen® IBD is a nutritionally complete formula suitable for oral and tube feeding, especially designed for the dietary management of Crohn’s Disease in paediatric (>5years) and adult patients. Ananthakrishnan A, et al. Long-term intake of dietary fat and risk of ulcerative colitis and Crohn's disease. Gut. 2014 May;63(5):776-84. MRI showed 5–10 cm patchy ileocecal inflammation (ICV). Colonoscopy showed deep ulcers in ICV. The patient had previously demonstrated loss of response to infliximab, adalimumab and azathioprine, and was being treated with ustekinumab weekly. A randomized controlled trial demonstrated that more than 80% of patients with severe acute refractory UC responded to CsA ( 58). It has been reported that the 8-day clinical remission rate (84.2 vs. 85.7%) of patients with severe UC treated with intravenous 4 mg/kg CsA is similar to that of patients treated with intravenous 2 mg/kg CsA ( 59). Stange et al. performed a randomized controlled trial to delineate the long-term effect of CsA on chronic active CD and found that CsA combined with low-dose steroids had no advantage over the sole use of low-dose steroids ( 60). Khalili H, et al. Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn's disease: results from two large prospective cohort studies. Gut. 2020 Sep;69(9):1637-1644.

Contains Transforming Growth Factor –ß2 (TGF-ß2) from patented manufacturing process. TGF-ß2 has natural anti-inflammatory properties to reduce inflammation associated with inflammatory bowel disease Levine A, Scaldaferri F, Sarbagili Shabat C, et al. OP01 Comparison of fecal transplantation, fecal transplantation with the novel UC diet or the UC diet alone for Refractory Mild to Moderate Active Ulcerative Colitis: The CRAFT UC randomized controlled trial. Journal of Crohn's and Colitis 2021:15(Supplement 1):S001. doi:10.1093/ecco-jcc/jjab165. Dietă completă din punct de vedere nutrițional, pe bază de cazeină, pentru regimul dietetic al pacienților cu boala Crohn. Cutie metalică cu capac de plastic cu închidere ermetică, conținând pudră 400 g ce se reconstituie cu apă ca soluție standard normocalorică sau hipercalorică. While several specialized diets may be helpful for some IBD patients, no one plan has been proven to prevent or control IBD with the exception of enteral nutrition, which is delivered in a nutrient-rich formula.The Crohn's Disease Exclusion Diet (CDED) is a whole foods diet designed to limit or exclude foods that may negatively affect the gut microbiome, inflammation, and the intestine’s ability to absorb nutrients or other functions. Other than intestinal symptoms, CD can lead to extra-intestinal ones such as bone, skin, ocular, and thromboembolic complications. These events were not investigated after EN and more specifically Modulen ® therapy. This goes along with other organ consequences. The most alarming repercussion is steatosis as non-alcoholic fatty liver disease is common in IBD. Considering TGF-β2 content, and the risk of hepatic fibrosis, hepatologists could avoid Modulen ® therapy for CD patients. Ananthakrishnan A, et al. A prospective study of long-term intake of dietary fiber and risk of Crohn's disease and ulcerative colitis. Gastroenterology. 2013 Nov;145(5):970-7. Ananthakrishnan A, et al. Zinc intake and risk of Crohn’s disease and ulcerative colitis: a prospective cohort study. Int J Epidemiol. 2015 Dec;44(6):1995-2005. Crohn’s disease (CD) and ulcerative colitis (UC) are chronic intestinal inflammatory diseases of unknown aetiology, characterized by a recurrent inflammatory condition. The pathophysiology is multifactorial and complex, involving an inappropriate immune activation of the gut mucosa in genetically susceptible individuals, triggered by an altered composition of the gut microbiota. The incidence of inflammatory bowel disease (IBD) has increased worldwide in developed nations and more recently in developing countries. 1, 2 This rapid increase in the incidence of IBD over the last half-century, particularly in developing countries, clearly points to the role of changing environmental factors intrinsically implicated in disease development. 1 Genes cannot change within such a short time frame, thus disease susceptibility remains almost identical over several generations. The differing role of genetics and the environment in disease development is clearly reflected by epidemiological data on immigrants from low- to high-IBD-incidence regions: where, the second generation of immigrants has the same risk of developing IBD as the local population living for generations in the same area. 3 A western lifestyle, including changes in dietary habits, urbanization and industrialization, has been proposed as one explanation for this worldwide increase in IBD. 4

CSs may be a kind of treatment selection for patients with UC who have not responded to mesalazine within 2–4 weeks, and those with mild-to-moderate CD, especially with extensive lesions ( 28). CSs have no proven efficacy in maintaining remission in IBD and should not be used for this purpose. Systemic oral CSs may result in numerous side effects, such as opportunistic infections, diabetes mellitus, hypertension, ocular effects, venous thromboembolism (VTE), osteoporosis, etc ( 29, 30). Steroid dependency or excess was found in ~15–40% of IBD patients ( 31, 32). Further investigation should define appropriate corticosteroid use and find measures for the improvement in CSs prescription management. The principles of UCED are to reduce or exclude certain dietary components that have been shown to have a negative effect on the microbiome–host interaction through several mechanisms: barrier function, mucosal immunity, colonic metabolites, and energy homeostasis. These include sulfated amino acids, dietary sulfur, processed foods, animal protein and saturated fat.

Food diversity offered within CDED is particularly well appreciated by patients and provides motivation for complying with the treatment. Access to support material and multiple recipes through the Modulife App is an asset for patients, and the latter reduce monotony. New perspectives in dietary management of Ulcerative Colitis The patient remained in remission for 27 months between April 2020 and July 2022. After a short period without Modulen and eating a free diet whilst overseas, the patient experienced a severe flare and obstruction in September 2022. The patient regained more control symptomatically by going on 6 weeks of EEN in addition to steroids and is now on phase 2 CDED+PEN (Modulen) again. In another randomized controlled trial 25, 44 adults with mild to moderate CD were treated with CDED. Patients were randomly assigned to CDED plus PEN (20) or CDED alone (24) for 24 weeks. The primary endpoint was clinical remission. Some studies in the scientific literature discuss fatty acids’ benefits to the intestinal mucosa. For instance, a palmitic acid-enriched diet has promoted B lymphocyte proliferation, IgA production, and cellular proliferation after a 75% bowel resection ( Figure 1, right panel) [ 51]. Even if the whole fatty acids content of Modulen ® is not specified, some of them spotlighted may contribute to clinical remission ( Figure 1, right panel) [ 32]. Among them, medium-chain triglycerides (MCT), which include caproic, caprylic, capric, and lauric acid esterified, are digested and absorbed easier than long-chain triglycerides. In comparison, MCT are shorter carbon chain, more hydrophilic, and then does not require bile acids or cholecystokinin. Their absorption is passive and permits to gain portal system without chylomicron formation ( Figure 1, right panel). MCT have shown their capacity to enhance intestinal mass and cellular proliferation at the proximal level [ 52], as well as villi length, crypts depth, and IgA production [ 53]. Additionally, studies have demonstrated that MCT can attenuate Clostridium difficile-induced inflammation [ 54]. More specific outcomes have been presented in in vitro studies with IPEC-J2 cells, in which caprylic acid enhanced the β-defensin 1/2 secretion [ 55] and capric acid attenuates the oxidation, IP, and cyclophosphamide-induced inflammation ( Figure 1, right panel) [ 56]. Dietary management of CD has been documented, but we know that what works for CD does not necessarily work for UC. 27

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