onNutrition

Patients with IBD have an increased risk of malnutrition. Significantly during flare-ups with increased energy consumption and often reduced food intake. This is due to malaise, pain, cramps, stenosis, fever and finally (in Crohn’s disease) malabsorption of both macro- and micronutrients. 

The nutritional status of IBD patients should be well documented, as malnutrition is associated with increased morbidity and mortality. Therefore, early intervention is essential as primary or adjuvant nutritional therapy. However, dieting is not necessary. A healthy, complete, preferably unprocessed and plant-based food is sufficient.

With flare-ups, deficiencies in vitamins and minerals (e.g. iron, calcium, potassium, vitamin B12 and folic acid) can sometimes arise. Flare-ups may be accompanied by diarrhoea. Diarrhoea is caused by inflammation and not by diet. It is, therefore, unnecessary to avoid foods for this reason. Even with diarrhoea, nutrients are still absorbed. 

With prolonged flare-ups, unwanted weight loss can occur. Many IBD patients have decreased appetite. Weight loss leads to malnutrition, which means the body has too few nutrients, such as protein and energy. During a flare-up, the need for proteins and energy increases, and the body has to fight against bacteria and inflammation. This costs extra energy. Malnutrition stands in the way of a speedy recovery.

Advice about nutrition by a dietitian is useful when there is:

• Flashes, complaints
• Possible nutrient deficiencies
• Unwanted weight loss

Screening for anaemia and iron, vitamin B12 and vitamin D deficiency should occur at least at the onset of the disease and after each flare-up.

The editorial board of IBD onPlay has compiled this animation based on clinical insights for practicality in combination with recent insights from the literature, including guidelines. The content is intended for educational and informational purposes and is not intended to replace guidelines or provide unambiguous advice in individual situations. No part of these animations may be copied in any way without the prior written permission of the editorial board. These animations were created in collaboration between the editorial board and FourCorners and made possible by Ferring B.V.