Nutrition management and self-perceived relapse triggers in patients with inflammatory bowel disease: results from the 3R web-based survey.

Abstract

Background and aims: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), requires long-term management. Besides pharmacotherapy, nutritional care is considered to be important; however, its real-world status in Japan remains unclear.

Methods: In this study, a web-based survey on 150 patients with IBD (CD, 75; UC, 75) was conducted between October 30 and November 4, 2025. Patient demographics, self-perceived relapse frequency, self-perceived relapse triggers, implementation of nutritional therapy, and the use of health management apps were evaluated.

Results: Patients with CD reported a higher self-perceived relapse frequency than did patients with UC (≥1 episode/year: 52% vs 32%) and were more likely to perceive diet as a self-perceived relapse trigger (77% vs 39%). Nutritional therapy was introduced in 53% of patients with CD and 12% of patients with UC, and 31% of patients with CD were currently using elemental diets. Most patients consumed 300-900 kcal/day, and some reported symptom improvement, although discontinuation was often due to the physician's decision or difficulty in intake. Dietary management awareness was higher in the CD group than in the UC group (77% vs 48%), whereas supplement use showed no significant difference (37% vs 29%). Health app usage was <10%, with common reasons for nonuse being a lack of awareness and perceived necessity.

Conclusions: Nutritional therapy is more frequently administered to patients with CD in Japan, suggesting its clinical relevance. Strategies are required to enhance dietary guidance, support the continued use of elemental diets, and promote digital health tools.