DIETARY THERAPY OF CHRONIC INFLAMMATORY DISEASES OF THE COLON IN MIDDLE SCHOOL-AGED CHILDREN

To choose the most appropriate therapeutic strategy for inflammatory bowel disease (IBD), it is necessary to determine the degree of inflammatory activity and its localization. Diet and nutrition should aim to support normal growth, bone mineralization, age-appropriate pubertal development, and social adaptation . Nutritional therapy is tailored according to the patient’s age, the severity of inflammation, and its extent and localization. Traditionally, dietary management during acute exacerbations of chronic pediatric IBD is based on Pevzner Diet No. 4, while during remission, nutrition approximates the standard diet for the child’s age group . Foods that increase gas production, stimulate intestinal secretion and motility, increase stool volume, or contain high amounts of coarse dietary fiber are excluded. Protein intake should be increased primarily through boiled meat, fish, and eggs. Protein requirements are calculated based on disease severity (approximately 0.8–1.1 g/kg body weight/day). In severe cases with significant protein deficiency, intake may be increased to 1.5 g/kg/day. In cases of secondary enteropathy with protein loss, intake can exceed 1.5 g/kg/day, then gradually reduced as the child’s condition improves . During acute exacerbations, milk and dairy products are excluded .