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Nutrition in Inflammatory Bowel Disease

  • Alan L. BuchmanEmail author
Chapter

Abstract

It is estimated that as many as 75 % of hospitalized patients with Crohn’s disease are malnourished [1]. The prevalence of malnutrition is significant even for patients considered to be in clinical remission. Bin et al. observed decreased handgrip strength of 73 % of subjects who had been in remission at least 3 months [2]. Similar observations were made by Valentini et al. despite the presence of normal body mass index (BMI) and serum albumin concentration [3]. In general, the likelihood of nutritional deficiencies is greater in patients with Crohn’s disease than in those with ulcerative colitis. Reduced intake of food because of abdominal cramping, nausea, and nutrient loss in diarrhea are prominent causes of weight loss in patients with IBD. Intestinal malabsorption also contributes to malnutrition in patients with active IBD, primarily those with Crohn’s disease involving the small intestine in whom entero-enteric fistulas that bypass large segments of the proximal intestine may also result in substantial nutrient malabsorption. Extensive mucosal disease, bacterial overgrowth proximal to strictures, and surgical resection all contribute to malabsorption and subsequent weight loss. Increased energy expenditure, as seen with fever, abscess or sepsis, or systemic inflammation, can also result in weight loss. Nutrient deficiency can result in altered cellular immunity with increased risk of infection, delayed wound healing, and in children, growth retardation. Therefore, it is important to identify those patients that are at potential risk of malnutrition. Medical and surgical management plans should then include prevention of, and correction of, nutritional deficits.

Keywords

Ulcerative Colitis Nutritional Support Short Bowel Syndrome Lactose Intolerance Serum Albumin Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Illinois at ChicagoGlencoeUSA

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