Malnutrition Assessment in Patients with Inflammatory Bowel Disease

Authors

  • Stephanie L. Gold, MD Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine, Mount Sinai, New York, NY
  • Maitreyi Raman, MD, MSc, FRCPC Department of Medicine, Division of Gastroenterology and Hepatology, University of Calgary

DOI:

https://doi.org/10.58931/cibdt.2023.119

Keywords:

inflammatory bowel disease, malnutrition

Abstract

Inflammatory bowel disease (IBD) affects over 6.8 million people worldwide and is highly associated with the development of malnutrition. Malnutrition in patients with Crohn’s disease (CD) and ulcerative colitis (UC) is often due to the following: decreased oral intake; food avoidance; side effects of medications; malabsorption; chronic enteric losses; altered anatomy from luminal surgery; and increased nutritional needs in the setting of active inflammation and a high catabolic state. Approximately 20%-80% of patients with IBD are estimated to be malnourished at some point during their disease course; this wide range is likely secondary to significant heterogeneity in the definition of malnutrition in the literature, and due to the lack of robust, validated tools to identify individuals who are malnourished. While malnutrition is traditionally thought of as under- nutrition or protein calorie malnutrition, there are other nutrition phenotypes of significance in patients with IBD including micronutrient deficiencies, sarcopenia and obesity (over-nutrition). Malnutrition is associated with poor outcomes in patients with IBD, including a high number of disease flares; impaired response to biologics; increased surgical complications; hospitalizations; and impaired quality of life, independent of disease activity. Given the significant prevalence of malnutrition, the impact it can have in patients with IBD, and its responsiveness to therapeutic interventions, it is crucial to accurately assess the nutritional status of patients at the time of diagnosis and regularly thereafter.

Author Biographies

Stephanie L. Gold, MD, Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine, Mount Sinai, New York, NY

Dr. Stephanie L. Gold is an Instructor of Medicine at the Icahn School of Medicine at Mount Sinai and a gastroenterologist at the Mount Sinai Hospital, with a focus on inflammatory bowel disease (IBD) and nutrition. Dr. Gold’s clinical interests include nutrition optimization for patients with IBD and the use of diet as an adjunct therapy. She established a unique Nutrition-IBD clinic where patients have access to an in-depth nutrition and muscle health assessment as well as dietary guidance and support to complement their IBD care. Her research interests include improving the identification of malnutrition, micronutrient deficiencies and sarcopenia in patients with IBD.

Maitreyi Raman, MD, MSc, FRCPC, Department of Medicine, Division of Gastroenterology and Hepatology, University of Calgary

Dr. Maitreyi Raman is a Gastroenterologist and Physician Nutrition Specialist, Clinical Associate Professor in the Department of Medicine and Division of Gastroenterology at the University of Calgary. She completed medical school at the University of Ottawa, and then Internal Medicine Residency at Dalhousie University, and subsequently a clinical nutrition fellowship at the University of Toronto. Dr. Raman has clinical and research interests in lifestyle as primary therapy for patients with digestive diseases. She investigates using dietary patterns and components in the management of digestive health disorders, and investigates the role of diet to modulate the gut microbiome and chronic inflammation in Inflammatory Bowel Diseases and Irritable Bowel Syndrome. In addition, Dr. Raman explores the role of the brain-gut axis through mind body interventions, and its impact on chronic disease outcomes.

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Published

2023-04-11

How to Cite

1.
Gold SL, Raman M. Malnutrition Assessment in Patients with Inflammatory Bowel Disease. Can IBD Today [Internet]. 2023 Apr. 11 [cited 2024 May 18];1(1):32–38. Available from: https://canadianibdtoday.com/article/view/1-1-5-gold_et_al

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Volume 1, Issue 1, April 2023

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