Malabsorption as a Major Driver of Chronic Inflammatory Enteropathy: Implications for Diagnosis and Diet Trials

Presentation Description / Summary: Chronic inflammatory enteropathy (CE) is a wide spectrum of heterogenous and ill-defined gastrointestinal (GI) disorders, often diagnosed based on persistent chronic GI signs and clinical response to therapy. Most cases are food-responsive with dietary trials alone often leading to clinical improvement or remission. While CE is often considered a predominantly immune-mediated disease, new studies reveal that malabsorption due to chronic mucosal remodeling is one major driver of the pathophysiology, often associated with dysbiosis. We will discuss novel findings about metabolic changes in CE, the interactions between diet, the microbiome and intestinal function, and how targeted and individualized dietary trials based on optimizing dietary macronutrients (fat, protein, carbohydrates) can help in the management of clinical signs. We will also discuss whether a novel protein source is needed in most CE cases.