Nutritional therapy

Nutritional therapy

Statement 1.15

All forms of nutritional therapy should be available to IBD patients, where appropriate, including exclusive enteral nutrition for Crohn’s Disease and referral to services specialising in parenteral nutrition.

Why is it important?

Malnutrition is a common problem for people with Inflammatory Bowel Disease (IBD), especially those with Crohn’s Disease. This is due to reduced food intake, increased nutrient requirements and increased gastrointestinal loss of nutrients, among other causes.

That’s why nutritional treatment and support are so important for patients with IBD. They are required to avoid iron deficiency, prevent osteoporosis and promote optimal growth and development for children.

In certain situations, such as for people with strictures or before an operation, there may be a need for specific dietary advice or supplementation. Enteral nutrition as primary or additional therapy can also be used to induce remission for those with active Crohn’s. It is often the treatment of choice for children as it avoids the use of steroids, which can affect growth.

When people have good levels of nutrition, clinical outcomes are better – so it’s important to use validated tools to screen and support people. It’s harder to pick up nutritional risk in children, but we know there is an impact on growth for 15-40% of children with IBD, so this should be monitored especially carefully. Iron deficiency is particularly common in children with IBD, along with other deficiencies including folic acid, zinc, magnesium, calcium, vitamins A, B12, D, E and K.

These factors make it essential to have a dietitian with specialist knowledge of IBD as part of the core IBD team. A multidisciplinary nutrition support team also needs to be available to advise those patients who may require more complex enteral and/or parenteral nutritional support.

I tried all the different diets for Ulcerative Colitis without finding any success, only problems and stress. I now realise the most important thing is to eat a balanced diet and enjoy my food.

Trevor, age 66, diagnosed with Ulcerative Colitis in 2010