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* = Presenting author

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

Background

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.

Methods

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.

Results

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 identifiedPatients primary issue n (%At risk of
Inadequate energy and protein31 (33)Malnutrition
Poor variety because of avoidance of 2 or more 
food groups25 (27)Nutrient deficiencies
Excessive energy15 (16)Weight gain/ overweight/ obesity
Inadequate fibre13 (14)Constipation
Inadequate calcium9 (9)Reduction in bone density
Inadequate fluid1 (1)Constipation and dehydration
Total94 (100)

Conclusion

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.