Catherine Wall, PhD NZRD
Malnutrition in IBD
Malnutrition can be a concern for individuals with IBD, since inflammation can impact the body’s ability to absorb and process nutrients. Understanding the causes and symptoms of malnutrition can empower patients and clinicians to identify and treat nutrient deficiencies as early as possible to prevent further complications.
- Reduced Appetite: Inflammation and discomfort in the digestive tract can lead to loss of appetite, making it challenging to consume sufficient calories and nutrients.
- Malabsorption: Inflammation can damage the lining of the intestines, impairing the absorption of nutrients from food. This can result in deficiencies of vitamins, minerals, and other essential nutrients.
- Increased Nutrient Loss: Chronic diarrhea and inflammation can cause increased loss of nutrients through stool. Loss of blood can lead to loss of iron and can increase the risk of iron deficiency.
- Metabolic Demands: The body's increased metabolic rate during periods of active inflammation can lead to increased nutrient requirements, making it harder to meet these demands through diet alone.
- Dietary Restrictions: Some individuals with IBD might avoid specific foods based on symptoms and disease activity, which can limit nutrient intake. Certain medications can also interact with the absorption of nutrients.
- Weight Loss: Unintentional weight loss is a common sign of malnutrition in IBD patients.
- Fatigue: Inadequate nutrient intake can lead to fatigue and decreased energy levels.
- Weakness: Malnutrition can result in muscle wasting and weakness.
- Immune Function: Nutrient deficiencies can compromise the immune system, potentially leading to increased susceptibility to infections.
- Delayed Healing: Poor nutrition can hinder the body's ability to heal and recover from inflammation or injury.
- Bone Health: Calcium and vitamin D deficiencies can impact bone health and increase the risk of osteoporosis.
- Screening tools: Both patient-led and dietitian-led screening tools can determine the risk of malnutrition. Common indicators are weight loss, low body mass index (BMI), reduced muscle mass, increased disease activity, poor appetite, reduced food intake, and food restriction behaviors.
Diagnosis and Management:
- Nutrition Assessments: Regular monitoring of nutritional status and dietary intake can identify deficiencies.
- Blood tests: Nutrient deficiencies can be detected with tests to identify levels of nutrients, including a variety of vitamins and minerals.
- Dietary Modifications: Working with a registered dietitian can help build a well-balanced diet that meets the individual's specific needs and tolerances.
- Supplementation: Depending on nutrient deficiencies, supplementation of vitamins, minerals, and other nutrients might be recommended.
- Medication Management: Proper management of inflammation through medications can help reduce the risk of malnutrition.
- Caloric Support: When oral intake is insufficient, medical nutrition therapy or even tube feeding might be necessary to provide adequate nutrition in severe cases.
Patients who suspect malnutrition should consult a healthcare professional as soon as possible. It's important for individuals with IBD to work closely with their healthcare team, including gastroenterologists and dietitians, to effectively manage both the underlying disease and the potential complications related to malnutrition.