Dealing with Malnutrition and IBD

Malnutrition is a well-known major complication of inflammatory bowel disease (IBD) and the prime reason behind chronic weight loss in patients.

The available data suggests that malnutrition affects a significant portion of patients with IBD. The estimates reveal that as many as 65-75% of Crohn’s disease (CD) patients and between 18-62% of patients with ulcerative colitis (UC) suffer some degree of malnutrition.

One study showed that malnourished patients were more likely to have active disease, be underweight, and have been hospitalized in the past 12 months. The study also found that undernourished patients have a significantly lower quality of life, both physical and mental, due to pain, loss of confidence, and unintentional weight loss.

Based on these findings, it becomes clear that managing diet and nutrition in Crohn’s disease and ulcerative colitis patients becomes a crucial part of disease management.

Dealing with Malnutrition and IBD

Nutritional Tips and Strategies to Prevent Malnutrition

A healthy balanced diet should be encouraged for IBD patients to avoid macronutrient and micronutrient deficiencies and malnutrition.

A well balanced, personalized diet allows adequate metabolic, physiological, and immunological function to maintain health, including wound and mucosal healing, an appropriate response to secondary infection, growth, and pregnancy.

Dietary modifications are often necessary to improve patients’ symptoms and quality of life. Patients should work alongside their doctors on finding the best nutritional changes for their dietary needs.

Exclusion Diets

Food intolerances are common in IBD patients, with some data suggesting the frequency is greater than 60%.

A patient may have multiple intolerances, including dairy products, cereal products, vegetables, and fruit. Although patients are strongly encouraged to identify food “triggers” within their diets, they should not exclude entire food groups without first consulting their doctors and nutritional specialists to avoid potential dietary deficiencies.

Low-Residue Diets

Several dietary elements can induce symptoms in many IBD patients. Some of these nutritional elements include high-fiber foods (e.g., whole grains, nuts, seeds, and fruit or vegetable skins) and foods that are difficult to break down mechanically, such as meat.

Eliminating such foods from the diet may reduce obstructive episode frequency and severity, which can generally be achieved without adverse nutritional consequences.

Dietary Modifications for Superadded IBS Symptoms

For IBD patients prone to experience IBS symptoms, which can significantly impact their quality of life, avoiding some foods and beverages can help manage functional symptoms.

Poorly digested short-chain carbohydrates, including fructose, lactose, and polyols, can increase gas production and fluid excretion in the gut, aggravating symptoms in susceptible individuals.

Patients with IBS symptoms should consult their doctors to get dietary advice and supporting information to eliminate these foods and effectively reduce their symptoms.

Dealing with Malnutrition and IBD

Lactose Intolerance

Lactose intolerance is widespread among patients with IBD.

Some patients have primary lactose intolerance. However, there is also an increased incidence due to secondary intolerance caused by the effects of the disease and its treatment on the small intestine.

Appropriate dietary modification is required for these patients. Replacing whole milk with skimmed or lactose-free alternatives may provide symptom relief to some, but some patients may do better with replacement products such as soy milk or rice-based beverages.

However, it is essential to emphasize that the widespread prohibition of dairy products is unnecessary and may be harmful.

 

At Altus Biologics, we’ve seen the devastating effects of malnutrition in IBD patients. The condition not only ravages their digestive system it also affects their physical and mental wellbeing. That is why we urge IBD patients to talk to their healthcare providers and share their concerns.

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