January 23, 2026
2 min read
Key takeaways:
- AGA clinical practice guidelines for IBD management have significantly shifted, emphasizing the importance of diet.
- Mediterranean and whole-food diets should be encouraged for most patients.
LAS VEGAS — AGA clinical practice guidelines for inflammatory bowel disease management have undergone “major shifts” in recent years, placing diet front and center and urging patients to adhere to Mediterranean or whole-food diets.
“We know that diet impacts the GI tract significantly, and it impacts the areas that we feel are the idiopathogenesis of IBD,” David Suskind, MD, professor of pediatrics in the division of gastroenterology at University of Washington Seattle Children’s Hospital, said during a presentation at Crohn’s & Colitis Congress. “It affects the microbiome in major ways, the mucosal layer in the GI tract, as well as the inflammatory process itself directly.”
He added: “We use diet for induction of remission as well as maintenance, and then back again to induction and maintenance again. It’s also important that this is not a talk you have with your patients once, and then you’re done with talking about diet: This should be a continual conversation.”
For Suskind, one of the most pivotal changes to AGA clinical practice guidance is the emphasis on “eating healthily.”
“The recommendations state that all of our patients, outside of a select few, should be following the Mediterranean diet or a whole-food diet — or simply avoiding a high-sugar Westernized diet,” he said.
Another significant shift involves how clinicians manage asymptomatic narrowings or strictures. In the past, patients were advised to follow a low-residue diet; however, newer data no longer support this approach.
“What the research is telling us is that fiber is still good,” Suskind said. “It should be soluble fiber, it should be fruits and vegetables that are cooked, peeled, mashed and chewed well. But fiber is not a no-no for narrowings in the GI tract.”
Other notable shifts in guidance for IBD management involves the use of interventional diets, such as exclusive enteral nutrition (EEN) and the Crohn’s disease exclusion diet. The updated recommendations now emphasize that these represent important options for adults, not just pediatric patients.
For Suskind, however, one of the most significant changes is the addition of dietary intervention for active disease, with guidelines endorsing the Crohn’s disease exclusion diet combined with partial enteral nutrition.
“EEN remains the mainstay of nutritional therapy in Crohn’s disease,” Suskind said. “It typically involves 6 to 10 weeks of exclusive formula nutrition, albeit we can adjust that plan to 2 to 4 weeks if that’s what gets us to the next step of therapy. Despite strong evidence and effectiveness, we don’t utilize it enough in our clinical practice.”
He emphasized to young investigators in the audience that “this is a great area to study, because this is the only intervention we have that has such [a] powerful impact, but is not necessarily an immune modulator.”
How can clinicians help their patients live healthier lives? Suskind recommends starting with the basic tenets of diet.
“We need to define healthy eating, focus on the positives of nutritional intervention, improve symptoms, improve nutritional repletion and growth, and address any concerns of our patients,” he said. “It’s important that we bring the subject up with our patients, because if we don’t, somebody else will and they may be giving incorrect information.”
For more information:
David Suskind, MD, can be reached at gastroenterology@healio.com.
Sources/Disclosures
Source:
Suskind, D. Role of diet in inflammatory bowel disease management and surgical optimization. Presented at: Crohn’s & Colitis Congress; Jan. 22-24, 2026; Las Vegas.
Disclosures:
Suskind reports consulting roles with Abbott and Nestlé. He also founded Nutrition in Immune Balance (NiMBAL).
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