Diet in Inflammatory Bowel Diseases: Efficacy, Tolerability, and Microbiome Effects Toward Personalized Management

Introduction: Inflammatory bowel disease (IBD) is increasingly recognized as a condition in which diet is not only a trigger for symptoms but also a potential tool for disease modulation. Mounting evidence links dietary patterns and specific nutrients to intestinal inflammation, microbiome composition, and mucosal repair, opening new avenues for personalized therapy. Diet interventions: Exclusive and partial enteral nutrition remain among the most effective nonpharmacologic strategies in Crohn's disease, while emerging data support the Mediterranean diet, specific carbohydrate diet, and low Fermentable Oligo-, Di-, Mono-saccharides And Polyols (FODMAP) approaches for symptom relief and quality-of-life improvement. Gaps and future directions: Nevertheless, evidence is often heterogeneous, with variability in dietary protocols, endpoints, and patient populations, making firm recommendations challenging. Adherence and long-term sustainability remain major barriers, underscoring the need for realistic, patient-centered approaches. By integrating current findings with clinical practice, diet can evolve from supportive care to a central component of multidisciplinary IBD management-if guided by robust evidence and tailored to individual needs. As research continues to refine the role of specific foods, nutrients, and patterns, dietary therapy holds promise not only to complement pharmacologic treatments but also to address the broader nutritional and metabolic needs of patients living with IBD.