P535 Major nutritional diagnoses amongst outpatient inflammatory bowel disease patients
A. Ferguson*1, C. Rogge2, E. Gruber1, R. Jennings1, M. Carrie1, J. Roberts2, T. Lee2
1Illawarra Shoalhaven Local Health District, Nutrition and Dietetics, Wollongong, Australia, 2Wollongong Hospital, Gastroenterology, Wollongong, Australia
The role of a dietitian in an IBD clinic is to identify and treat nutritional inadequacies. Patients with nutritional concerns in an Australian regional multidisciplinary clinic were reviewed by an IBD dietitian following nutritional screening using short nutrition assessment questionnaire (SNAQ ©) or referral from gastroenterologists, nursing staff, or the patient. From the dietitian’s assessment, this study aims to explore and categorise the dietary diagnoses commonly faced by patients with IBD.
Over 2 years, data were prospectively collected on patients seen for a comprehensive assessment with a dietitian. This included IBD type, gender, SNAQ © score, and a validated nutrition assessment tool (subjective global assessment [SGA]). Up to 4 dietary issues were recorded, as identified by the dietitian. These issues formed the basis of education and recommendations to improve nutritional intake and status.
In total, 110 patients had a comprehensive assessment completed by a dietitian, and 94 (85%) were identified to have major inadequacies in dietary intake. Of these, 48 (51%) were male, and 67 (71%) patients had Crohn’s disease, and 27 (29%) had ulcerative colitis. Further, 86 patients were screened using the SNAQ© screening tool, with 38 (40%) patients scoring 2 or more, suggesting a risk of malnutrition. The SGA tool was completed on 93 patients, with 32 (34%) assessed as mildly to moderately malnourished (SGA B), and 6 (6%) as severely malnourished (SGA C). Multiple dietary issues were common (72% patients had 2 or more issues), and 37 (39%) patients had inadequate energy and protein as one of their 4 dietary shortfalls. When identifying a patient’s primary dietary issue (Table 1), 6 major inadequacies were commonly identified in IBD patients. It is noted that both inadequate and excessive energy (associated with corticosteroid use) are often seen in this cohort.
Table 1 Common dietary issues in IBD patients
|Dietary issue identified||Patients primary issue n (%||At risk of|
|Inadequate energy and protein||31 (33)||Malnutrition|
|Poor variety because of avoidance of 2 or more food groups||25 (27)||Nutrient deficiencies|
|Excessive energy||15 (16)||Weight gain/ overweight/ obesity|
|Inadequate fibre||13 (14)||Constipation|
|Inadequate calcium||9 (9)||Reduction in bone density|
|Inadequate fluid||1 (1)||Constipation and dehydration|
Malnutrition continues to be a significant problem in patients with IBD. There were 6 major dietary issues commonly seen in patients with IBD, as identified by the dietitian, including both inadequate and excessive energy intake.