Abstract
Malnutrition is a common condition encountered in patients with inflammatory bowel disease (IBD) and is often associated with sarcopenia (the reduction of muscle mass and strength) which is an ever-growing consideration in chronic diseases. Recent data suggest the prevalence of sarcopenia is 52% and 37% in Crohn’s disease and ulcerative colitis, respectively, however it is challenging to fully appreciate the prevalence of sarcopenia in IBD. Sarcopenia is an important consideration in the management of IBD, including the impact on quality of life, prognostication, and treatment such as surgical interventions, biologics and immunomodulators. There is evolving research in many chronic inflammatory states, such as chronic liver disease and rheumatoid arthritis, whereby interventions have begun to be developed to counteract sarcopenia. The purpose of this review is to evaluate the current literature regarding the impact of sarcopenia in the management of IBD, from mechanistic drivers through to assessment and management.
Highlights
Malnutrition, defined as ‘a state resulting from the lack of intake or uptake of nutrition that leads to altered body composition and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease’ [1], is frequently observed in patients with inflammatory bowel disease (IBD)
It is clear that sarcopenia has a negative impact on length of hospital stay, surgical outcomes and clinical course
Sarcopenia can be a strong predictor of outcomes such as the need for surgical intervention and post-operative complications
Summary
Malnutrition, defined as ‘a state resulting from the lack of intake or uptake of nutrition that leads to altered body composition and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease’ [1], is frequently observed in patients with inflammatory bowel disease (IBD). Malnutrition is known to be a key driver for muscle loss and the consequential loss of function [1], a condition known as sarcopenia. Sarcopenia was first described by Rosenburg in 1988 and was defined as the age-related loss of muscle mass [2], it is clear that sarcopenia can occur as a result of chronic illness, inactivity and inflammation [3]. UC is an idiopathic chronic inflammatory disorder which targets the colonic mucosa, usually in a continuous pattern, extending to varying degrees from the rectum, proximally to the remaining colon
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