Vetnews | Februarie 2025 42 « BACK TO CONTENTS Inflammatory bowel disease (IBD) is a broad term used to describe any gastrointestinal disorders that are characterised by chronic or recurrent GI signs with histological evidence of intestinal inflammation1. Clinical signs include diarrhoea, with or without weight loss, vomiting and anorexia. Moderate and severe cases may also be associated with protein-losing enteropathy (PLE). IBD is often placed under the umbrella term of ‘chronic inflammatory enteropathy’2 and there are several other diseases that are associated with chronic intestinal inflammation (Table 1), which should be ruled out before we can reach a diagnosis of idiopathic IBD, which, by definition is of unknown cause1. Histopathological assessment of intestinal biopsies is the gold standard for diagnosis of IBD, as it is necessary to document intestinal inflammation. It also seems likely that idiopathic IBD is, in fact, a group of diseases and not a single disease entity as we often see variations in histopathology with regards to the distribution within the GI tract, severity, and pattern within the lamina propria. Lymphoplasmacytic Enteritis (LPE) is the most common form of idiopathic IBD reported in both dogs and cats, with Eosinophilic (gastro-)enteritis (EGE) being the second most common variant reported. It is also interesting to note that canine and feline IBD bear little resemblance histologically or clinically to ‘human’ IBD such as Crohn’s disease and Ulcerative colitis1. The aetiology of IBD is unknown, but it is likely due to loss of immunological tolerance to luminal antigens from both bacteria and dietary components. This loss of tolerance likely results from a disruption of the mucosal barrier, dysregulation of the immune system, and/or disruption of the gut microbiome (dysbiosis)1,3. The gut microbiota plays a key role in maintaining gut physiology, protecting against pathogens, shaping the immune system, and providing beneficial metabolites to enterocytes via fermentation. Gut microbiota shows remarkable pliability to environmental changes (particularly diet), and the benefit of an appropriate diet has long been recognised in the treatment of patients with IBD. A healthy gut microbiome also provides other beneficial effects such as immunomodulatory, anti-diarrhoeal, and regulatory effects on GI motility. The short-chain fatty acids that are the end product of intestinal bacterial fermentation are also known to improve epithelial barrier integrity and alleviate gut inflammation in vivo.3 This highlights the importance of providing a diet that supports a healthy gut microbiome for IBD cases, through the inclusion of prebiotics, fibre content and highly digestible proteins. Inflammatory Bowel Disease & Diet By Dr A Kaldelis Chronic infection Pathogenic bacteria Food Allergies Other primary GI Diseases Giardia Campylobacter spp. Adverse food Lymphoma Histoplasma Salmonella spp. reaction Lymphangiectasis Toxoplasma pathogenic E .coli Idiopathic Mycobacterium Prototheca Pthyium and other zygomycetes Table 1: Causes of Chronic Intestinal Inflammation
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