Thématique :
Originalité :
Très original
Solidité :
Doit faire évoluer notre pratique :
Nom du veilleur :
Docteur Stéphane NAHON
Coup de coeur :
Clinical Gastroenterology and Hepatology
  2016 Aug;14(8):1130-6  
  doi : 10.1016/j.cgh.2015.12.029  
  Avoidance of Fiber Is Associated With Greater Risk of Crohn's Disease Flare in a 6-Month Period  
  Brotherton CS, Martin CA, Long MD, Kappelman MD, Sandler RS  


Chronic inflammatory bowel diseases (IBDs) have been associated with an abnormal mucosal response to the gastrointestinal microbiota. Although dietary fiber affects the gastrointestinal microbiota, there is limited information on the role of fiber on IBD activity. We investigated factors associated with fiber consumption and whether it was associated with flares in patients with IBD.


We collected a completed 26-item dietary survey from 1619 participants in the Crohn's and Colitis Foundation of America Partners Internet cohort (Crohn's disease, 1130; ulcerative colitis/indeterminate colitis, 489). Eligible individuals were in remission based on disease activity index at baseline and completed a follow-up survey 6 months later. Fiber and whole grain consumption were categorized into quartiles and deciles. Disease flare at 6 months was defined as a disease activity index score exceeding remission cutoff values, and/or an IBD-related surgical procedure or hospitalization since baseline.


Participants with longer duration of disease, past history of surgery, and past IBD hospitalization ate less fiber. The risks for disease flare differed by disease type. Compared with those in the lowest quartile of fiber consumption, participants with Crohn's disease in the highest quartile were less likely to have a flare (adjusted odds ratios [OR], 0.58; 95% confidence interval [CI], 0.37-0.90). Participants with Crohn's disease who reported that they did not avoid high-fiber foods were ∼40% less likely to have a disease flare than those who avoided high-fiber foods (adjusted OR, 0.59; 95% CI, 0.43-0.81). There was no association between fiber intake and flares in patients with ulcerative colitis (adjusted OR, 1.82; 95% CI, 0.92-3.60).


Intake of dietary fiber is associated with reduced disease flares in patients with Crohn's disease, but not UC. Recommendations to limit dietary fiber should be re-evaluated.

Question posée
La consommation de fibres est-elle associée à une récidive d’une MICI ?
Question posée
1) La consommation de fibres n’est pas associée à une récidive de la RCH. 2) Une consommation importante de fibres était associée à une réduction de la fréquence de la maladie de Crohn.

L’alimentation et la consommation de fibres est une préoccupation permanente des patients atteints de MICI y compris quand leur maladie est en rémission. On observe très souvent un évitement des fibres dans la crainte (non fondée ?) d’une récidive de la maladie. On pourra s’appuyer sur ce travail afin d’inciter nos patients à consommer une quantité raisonnable de fibres quand la maladie est en rémission.