Introduction Malnutrition in inflammatory bowel disease (IBD) can occur as a result of poor dietary intake, malabsorption, self-imposed dietary restrictions and treatment. High rates of malnutrition (80%) have previously been described in hospitalised patients with severe active disease.1In remission malnutrition is not frequently encountered and one third of patients with Crohn–s Disease are reported to be overweight.2The aim of this audit was to assess the nutritional status of IBD patients attending an outpatient clinic in a tertiary referral centre.
Method This was a prospective audit completed from June–October 2014. All IBD patients were asked to complete a malnutrition screening tool based on national guidelines.3Height and weight were measured by nurses and patients were asked to recall any weight loss over the last 3–6 months. Patients were identified as malnourished if they had a body mass index (BMI) <18.5 kg/m2, unintentional weight loss >10% within the last 3–6 months, or a BMI <20 kg/m2and weight loss >5% over the last 3–6 months.
Results One hundred patients completed the audit, 58 females and 42 males with a mean age of 47 ± 18 years. Fifty four patients (54%) had Crohn–s Disease, 45 had Ulcerative Colitis (45%) and 1 had Indeterminate Colitis (1%). A third of patients (33%) had undergone surgical resection. Mean weight was 68.2 ± 14.1 kg and mean BMI was 24.4 ± 4.7 kg/m2. Thirty eight patients (38%) experienced weight loss over the last 3–6 months. Only 7 patients (7%) were classified as malnourished whereas over a third of patients (37%) had a BMI >25 kg/m2similar to previous studies.4Of the malnourished patients, 3 had active disease, 2 had undergone a flare up in the last 3–6 months, 1 had short bowel and 1 had chronic fatigue.
Conclusion A low prevalence of malnutrition was demonstrated in IBD patients based on national guidelines. BMI is a crude measure of nutritional status and does not necessarily exclude malnutrition or changes in body composition. More sensitive measures of nutritional status including skinfold thickness and muscle circumferences are required to identify changes in lean body mass in the context of the obesity epidemic.
Disclosure of interest None Declared.
Harries and Heatley, Postgrad Med J. 1983;59:690–7
Vadan et al. Clin Nutr. 2011;30:86-91
Bin et al. Dig Dis Sci. 2010;55:137