Nutritional Assessment in Patients with Inflammatory Bowel Disease

Abstract

Abstract Background Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract, which clinically contains Crohn’s disease, ulcerative colitis, and other conditions. The inflammation of the intestinal mucosa in IBD is characterized by episodes of abdominal pain, diarrhea, bloody stools, weight loss, and the influx of neutrophils and macrophages that produce cytokines, proteolytic enzymes, and free radicals that result in inflammation and ulceration. Aim of the Work The aims of our study is to assess the nutrient status of individuals with CD and UC in relation to the recommended nutrient intake values, anthropometric measures, and biochemical indices of nutrition, and to determine the extent to which reduced food and nutrient intake contributes to the nutrition deficiencies in this population. Materials and Methods This was across-sectional study was conducted on patients with IBD, including Crohńs disease (CD), ulcerative colitis (UC)and undtermined colitis, who attended to the outpatient clinic for IBD of the Department of Internal Medicine, University Hospital of Ain Shams University, between january 2020 to july 2020. 90 patients with IBD (65 UC patients, 22 CD patients and 3 UD colitis) were included in the study. Results Our study show that The majority of our IBD patients showed a normal BMI indicating that malnutrition, especially underweight, is not as common a described in former studies with up to 85% in IBD patients. Our study show that majority of patients are suffering from GI upset following certain meals, all of them are suffering from flatulance, some of them suffering from nausea, vomiting, heart burn and 79(87.7%) patients are suffering from diarrhea, most of patients with crohns disease are suffering from constipation, and some of them are suffering from intestinal colick. So Many patients with IBD suppose that the diet influences the courseof their disease or even cause a relapse Our study groups showed an unfavorable ratio of essential fatty acids (FA) compared to the recent guidelines. Whereas the ratio of the n-6 fatty acid linolic acid (LA) to the n-3 fatty acid α-linolenic acid (ALA) should be 5:1, the actual ratio was more than in all participants because of the high incidence of margarine ingestion. Conclusion The worldwide rising incidence of IBD is paralleled by a ―Westernization‖ of dietary habits in developing countries. It is therefore obvious that, in addition to a genetic influence, environmental factors, especially diet, undoubtedly play a major role in the development of IBD. Impairment of nutritional status in BID patients has a multifactorial etiology. Main reasons include suboptimal energy intake, malabsorption, enteric nutrient loss, increased basal energy expenditure, and medications.