P815 Diet, nutrition, and the multidisciplinary approach in adults with Inflammatory Bowel Disease
Playford, C.(1)*;Asghar, Z.(1);Armstrong, S.(1);Ngomba, R.(2);Rochford, A.(3);
(1)University of Lincoln, Health and Social Care, Lincoln, United Kingdom;(2)University of Lincoln, Pharmacy, Lincoln, United Kingdom;(3)Royal Free London Hospitals, NHS Foundation Trust, London, United Kingdom;
Background
Patients with Inflammatory Bowel Disease (IBD) may associate dietary triggers with symptoms and even relapse of the disease, yet this is rarely acknowledged and included in treatment plans. Patients often self-impose dietary restrictions and manipulate their diet which can have significant health complications including nutrient deficiencies and malnutrition1. This often leads to a worse disease state, poorer clinical outcomes, and a reduced quality of life for these patients2.
Methods
A self-administered survey was digitally created with Crohn’s and Colitis UK (CCUK) and advertised through the CCUK website and their social media accounts. Patients with IBD aged ≥18 years were identified through convenience sampling. Those who were three months peri-operative or had a stoma were excluded from the study as their nutritional needs and experiences were likely to be more complex. Statistical Package for Social Sciences (version 27) was used for statistical analysis. A P-value of <0.05 was considered statistically significant.
Results
267 participants completed the survey, 77.5% were female, 30% of participants were aged 36-45 years and 53.9% had Crohn’s disease. 44.9% of participants had been diagnosed with IBD for >10 years. 90% of participants believed that food impacted on their disease at least some of the time. 77% reported that dietary therapy may be useful in managing their disease (P-value < 0.001). Table 1 highlights where patients with IBD source dietary information. 93% of patients report a ‘trial and error’ approach to dietary manipulation to reduce their symptoms. Access to formal dietetic advice is extremely limited and reported by only 13% of participants. The majority of participants (78.7%) reported that a multidisciplinary approach was ‘very important’ in IBD care despite 68.2% reporting no access to a multidisciplinary team (P-value = 0.006).
Table 1. Sources of IBD dietary information
Conclusion
Diet plays an important role in the disease course for patients with IBD; however, our respondents reported poor dietary support from healthcare professionals. This may lead to unsupervised dietary restrictions based on poor sources of information that can cause or worsen nutrient deficiencies and lead to adverse health outcomes. Patients with IBD should have access to high quality dietary advice to help manage the disease.
References:
1. Nazarenkov N, Seegar K, Beekan L, et al. Implementing dietary modifications and assessing nutritional adequacy of diets for Inflammatory Bowel Disease. Gastroenterology & Hepatology. 2019; 15: 133-144.
2. Balestrieri P, Ribolsi M, Guarino M, et al. Nutritional aspects in Inflammatory Bowel Disease. Nutrients. 2020; 12: 1-11.