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* = Presenting author

P598 Dietetic intervention and nutritional status in adult patients with Crohn’s disease: preliminary results

A. Dell’Era*1, V. F. Bernardo De Almeida2, L. Cioni3, A. Massari4, F. Muzio2

1UOC Gastroenterologia, Ospedale L. Sacco. Università degli Studi di Milano, Dipartimento di Scienze Biomediche e Cliniche, Milano, Italy, 2Servizio di Dietologia e Nutrizione Clinica, Ospedale L. Sacco, Milano, Milano, Italy, 3Servizio di Dietologia e Nutrizione Clinica, Ospedale L. Sacco, Milano, Italy, 4UOC Gastroenterologia, Ospedale L. Sacco, Milano, Milano, Italy

Background

Patients with Crohn’s disease are often at risk of malnutrition due to disease activity, diarrhoea and malabsorption, poor intake (in terms of quantity for loss of appetite and quality for dietary disbeliefs). The aim of the study was to investigate the prevalence of malnutrition and its modification with dietary counselling and supplementation with polymeric feed (Modulen IBD, Nestlè) in case of need.

Methods

adult patients with ileo-colic Crohn’s disease admitted in Ospedale L. Sacco were evaluated at baseline and after 3 months, assessing blood analysis, body mass index (BMI), unintentional weight loss in the previous 6 months, waist and non-dominant arm circumference, subjective global assessment scale (SGA), malnutrition universal screening tool (MUST), tricipital and bicipital fold, hand dynamometer test (HDT) and bioimpedance analysis (BIA). An accurate dietary anamnesis was performed. Data are reported as percentages or as medians (range) as appropriate.

Results

In total, 25 patients (13 males) were enrolled; 8 received polymeric feed supplementation. Table 1 shows the baseline values for the evaluated parameters.

Table 1 Baseline data

Lean mass values and intracellular water are lower than those of the general population (in particular the lowest values of the range). After 3 months patients supplemented with Modulen IBD had better BMI, MUST, SGA, weight and HDT than controls (table 2).

Table 2 Different parameters between baseline and 3-month follow-up in Modulen IBD and Control Group

Dietary anamnesis showed that only 56% of patients consumed milk but 92% consumed cheese without symptoms; 28% consumed legumes, 76% vegetables and 60% fruits; 52% assumed high quantities of simple sugars. At 3 months, after dietary counselling, 18% of patients not consuming milk started consuming it; 44% of patients started or increased eating fruits and/or vegetables; and 20% reduced sugar intake.

Conclusion

Malnutrition is an important issue in patients with Crohn’s disease but commonly used tools for assessing it may not correctly estimate it. Dietary advice with appropriate polymeric feed supplementation and correction of dietary disbeliefs may help in the correct management of the patients.