New Research Summary - High Prevalence of Micronutrient Deficiencies in new IBD Patients Early in Disease Course
Background
It is well known that patients with inflammatory bowel disease (IBD) are at an increased risk of malnutrition.
Malnutrition in IBD may result from many mechanisms including decreased oral intake, food trigger avoidance, medication effects, malabsorption, volume loss, altered anatomy due to prior surgery, and increased nutritional needs in the setting of active inflammation. In addition, although commonly overlooked, micronutrient deficiencies associated with restrictive diets, altered postsurgical anatomy, and untreated inflammation may occur in patients with IBD and is estimated to effect up to 50% of patients.
Malnutrition has been associated with poor clinical outcomes in patients with IBD, including increased numbers of flares, impaired response to medical therapy, higher rates of surgical complications, reduced quality of life, and increased length of stay in those hospitalized for an IBD-related complication.
What did this study look at?
The goal of this study was to define the prevalence of malnutrition and micronutrient deficiencies in recently diagnosed IBD patients and to compare the performance of existing malnutrition screening tools in identifying IBD patients at increased risk for malnutrition.
This study look at the records of 182 IBD patients 18 years of age and older with a diagnosis of IBD within the preceding 18 months.
What did they find?
This study found that patients with recently diagnosed inflammatory bowel disease have a high prevalence of malnutrition as well as micronutrient deficiencies (over 30% of IBD patients in this study). The study also found that both the Malnutrition Universal Screening Tool and Saskatchewan IBD Nutrition Risk Tool can be used to identify those at increased risk of malnutrition.
Whats the take away?
Patients with recently diagnosed IBD are at high risk of nutrient deficiency but the majority of patients with inflammatory bowel disease are not being screened for malnutrition routinely; this study highlights the importance of screening and identifies which tools have the highest sensitivity to screen patients in a clinical setting.
Whats can you ask your IBD team for?
When you are newly diagnosed ask for a blood test to check your iron, vitamin D, vitamin B12 and folate at the very least, and ask to be referred to a Dietitian or seek one out privately.
If you are not newly diagnosed you should still have your nutrient status monitored. Blood tests should be carried out at least every 12 months in remission but more regularly during a flare.
If you are newly diagnosed and want support with your diet, nutrition and IBD journey we can help.
At The NALM Clinic we have a specialist gastroenterology Dietician (Jess) and an IBD specialist Nutritional Therapist (Clemmie) and we can guide you as to how to reduce your risk of nutrient deficiency and how to navigate diet with IBD.
If you would like support with your IBD please book a call with me via the button below.
Reference
Stephanie L Gold, MD, Loren G Rabinowitz, MD, Laura Manning, MPH, RDN, CDN, Laurie Keefer, PhD, William Rivera-Carrero, MD, Stephanie Stanley, MS, Alexis Sherman, RN, Ana Castillo, RN, Stacy Tse, PharmD, Amanda Hyne, MSW, Kristina Matos, MSW, Benjamin Cohen, MD, Ari Grinspan, MD, Jean-Frederic Colombel, MD, Bruce E Sands, MD, MS, Marla C Dubinsky, MD, Ryan C Ungaro, MD, MS, High Prevalence of Malnutrition and Micronutrient Deficiencies in Patients With Inflammatory Bowel Disease Early in Disease Course, Inflammatory Bowel Diseases, 2022;, izac102, https://doi.org/10.1093/ibd/izac102