Perioperative Nutritional Considerations In Patients With Inflammatory Bowel Disease
DOI:
https://doi.org/10.58931/cibdt.2024.2123Abstract
Despite significant advances in medical therapy for inflammatory bowel disease (IBD) in recent decades, surgical management remains common in the setting of both Crohn’s disease (CD) and ulcerative colitis (UC). While the risk of colectomy for UC has declined in the biologic era, most patients with CD will undergo at least one intestinal resection in their lifetime. Preoperative nutritional status is a wellestablished determinant of surgical morbidity. Surgery elicits a metabolic stress response that is proportional to the extent of surgical injury. Adequate lean body and micronutrient stores are needed for healing of surgical incisions, and the individual must be metabolically capable of anabolism for tissue repair. Deficits at any point in this process may lead to complications including anastomotic failure, surgical site infections, delayed return of gastrointestinal (GI) function, and postoperative physical disability with prolonged length of hospital stay.
References
Barnes EL, Lightner AL, Regueiro M. Perioperative and postoperative management of patients with Crohn’s disease and ulcerative colitis. Clin Gastroenterol Hepatol. 2020;18(6):1356-66. DOI: https://doi.org/10.1016/j.cgh.2019.09.040
Sobotka L, Allison SP, European Society for Clinical N, Metabolism. Basics in clinical nutrition. Fifth edition. ed. Prague: Galén; 2019. XXXIV, 676 pages.
Weimann A, Braga M, Carli F, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745-61. DOI: https://doi.org/10.1016/j.clnu.2021.03.031
Gold SL, Raman M. Malnutrition Assessment in patients with inflammatory bowel disease. Canadian IBD Today. 2023;1(1):35-42. DOI: https://doi.org/10.58931/cibdt.2023.119
Ryan E, McNicholas D, Creavin B, et al. Sarcopenia and inflammatory bowel disease: a systematic review. Inflamm Bowel Dis. 2019;25(1):67-73. DOI: https://doi.org/10.1093/ibd/izy212
Bischoff SC, Bager P, Escher J, et al. ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr. 2023;42(3):352-79. DOI: https://doi.org/10.1016/j.clnu.2022.12.004
Adamina M, Gerasimidis K, Sigall-Boneh R, et al. Perioperative dietary therapy in inflammatory bowel disease. J Crohns Colitis. 2020;14(4):431-44. DOI: https://doi.org/10.1093/ecco-jcc/jjz160
Chiu E, Oleynick C, Raman M, et al. Optimizing inpatient nutrition care of adult patients with inflammatory bowel disease in the 21st century. Nutrients. 2021;13(5):1581. DOI: https://doi.org/10.3390/nu13051581
Yamamoto T, Lightner AL, Spinelli A, et al. Perioperative management of ileocecal Crohn’s disease in the current era. Expert Rev Gastroenterol Hepatol. 2020;14(9):843-55. DOI: https://doi.org/10.1080/17474124.2020.1802245
Gold SL, Raman M. Editorial: a formula shake each day keeps the complications away - the tolerability and effect of orallydelivered enteral nutrition in improving post-operative outcomes in patients with Crohn’s disease. Aliment Pharmacol Ther.
;56(4):739-40.
Schwartz E. Perioperative parenteral nutrition in adults with inflammatory bowel disease: a review of the literature. Nutr Clin Pract. 2016;31(2):159-70. DOI: https://doi.org/10.1177/0884533615594011
Day A, Wood J, Melton S, Bryant RV. Exclusive enteral nutrition: An optimal care pathway for use in adult patients with active Crohn’s disease. JGH Open. 2020;4(2):260-6. DOI: https://doi.org/10.1002/jgh3.12256
Meade S, Patel KV, Luber RP, et al. A retrospective cohort study: pre-operative oral enteral nutritional optimisation for Crohn’s disease in a UK tertiary IBD centre. Aliment Pharmacol Ther. 2022;56(4):646-63. DOI: https://doi.org/10.1111/apt.17055
Fiorindi C, Cuffaro F, Piemonte G, et al. Effect of long-lasting nutritional prehabilitation on postoperative outcome in elective surgery for IBD. Clin Nutr. 2021;40(3):928-35. DOI: https://doi.org/10.1016/j.clnu.2020.06.020
Zangenberg MS, Horesh N, Kopylov U, et al. Preoperative optimization of patients with inflammatory bowel disease undergoing gastrointestinal surgery: a systematic review. Int J Colorectal Dis. 2017;32(12):1663-76. DOI: https://doi.org/10.1007/s00384-017-2915-4
Seifarth C, Augustin LN, Lehmann KS, et al. Assessment of risk factors for the occurrence of a high-output ileostomy. Front Surg. 2021;8:642288. DOI: https://doi.org/10.3389/fsurg.2021.642288
Bridges M, Nasser R, Parrish C. High output ileostomies: the stakes are higher than the output. Pract Gastroenterol. 2019.
Bering J, DiBaise JK. Short bowel syndrome: Complications and management. Nutr Clin Pract. 2023;38 Suppl 1:S46-S58. DOI: https://doi.org/10.1002/ncp.10978
Bielawska B, Allard JP. Parenteral nutrition and intestinal failure. Nutrients. 2017;9(5):466. DOI: https://doi.org/10.3390/nu9050466
Gold SL, Manning L, Kohler D, et al. Micronutrients and their role in inflammatory bowel disease: function, assessment, supplementation, and impact on clinical outcomes including muscle health. Inflamm Bowel Dis. 2023;29(3):487-501. DOI: https://doi.org/10.1093/ibd/izac223
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Canadian IBD Today
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.