Download Inflammatory Bowel Disease and Nutrition Therapy

Inflammatory Bowel Disease
and Nutrition Therapy
Why is nutrition important?
Nutrition plays an important role in the treatment of Inflammatory
Bowel Disease (IBD). A healthy diet can help prevent malnutrition and
correct nutrient deficiencies. Good nutrition will make you feel better,
improve your body’s ability to heal, improve the way your immune
system functions, and enhance your quality of life.
What is malnutrition?
Malnutrition occurs when there is a lack of nutrients being provided
to the body. Weight loss, especially rapid or unintentional weight
loss, is a common indication of malnutrition.
Why are IBD patients at risk for malnutrition?
In IBD, various parts of the gastrointestinal tract are inflamed. The
inflammation can lead to diarrhea, pain and nausea. When these symptoms are present, patients with IBD do
not feel well and may not be meeting their nutrition needs because they do not feel like eating. The following
factors place a patient with IBD at risk for malnutrition:
Loss of appetite
Decreased food intake
Food intolerances
Increased nutrient requirements
Side effects of medications
Elimination diets
In some cases, malabsorption of nutrients
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What are the most common nutrient deficiencies in IBD?
Most Common
Nutrient Deficiencies
Functions of the
Nutrient
Food Sources
Energy (Calories)
Provides the body with energy to
perform daily tasks and maintain a
healthy weight.
Maintains muscle, helps promote
wound healing.
Helps our red blood cells transport
oxygen throughout our bodies.
Lack of iron may result in anemia.
Plays a key role in the functioning
of the brain and nervous system
and in the formation of blood.
Important for production of
healthy new cells.
Important for maintaining healthy
bones.
Fat, carbohydrates, and protein
together contribute to overall
energy.
Meat, nuts, fish, poultry, eggs, &
dairy.
Meat, fish, poultry, whole grains,
enriched breads, & fortified
breakfast cereals.
Meat, fish, poultry, dairy products,
& eggs.
Protein
Iron
Vitamin B12
Folic Acid
Calcium
Vitamin D
Helps body absorb calcium and
important for a healthy immune
system.
Leafy green vegetables, enriched
and whole grain products.
Dairy products, fortified soy
products or orange juice, almonds,
& canned salmon/sardines with
bones.
Sunlight, fortified milk, eggs, organ
meats & vitamin D supplements
You may need to supplement your diet with nutrition supplements. Your dietitian will determine which supplements may be necessary to meet all your nutrition requirements.
What diet should patients with IBD follow?
There is no specific diet for patients with IBD. Diet is very individual because it depends on your diagnosis, the
location of the disease and status of your disease (remission or a “flare-up”). Intolerances to foods vary from
patient to patient; for example some patients have difficulty tolerating milk products while others report no
difficulties.
When you are free of symptoms and your IBD is in good control, there is no need to follow a special diet. If you
are having a ‘flare up” of IBD, modifying your diet can be helpful in controlling symptoms such as bloating,
diarrhea and abdominal pain.
The most important change that you can make to you diet is to eat an individualized healthy, balanced diet
that tastes good and makes you feel well. If your diet is well balanced you should be able to maintain your
weight and have the energy to complete your daily activities.
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What happens if I remove foods or food groups from my diet?
People living with IBD will often remove foods or food groups from their diet, in hopes of preventing symptoms
of IBD. Removing foods or whole food groups from your diet for an extended period can place you at nutrition
risk. Some of these nutrition risks include nutrient deficiencies, malnutrition, weight loss, and fear of eating or
food obsessions. It is important to tell your doctor and dietitian if you are removing foods or food groups from
your diet, so they can provide you with alternate food choices or supplements to ensure you are receiving the
best nutrition possible.
Where do I go for individualized help with my diet?
You can speak to a dietitian about how to modify your diet to meet your nutrition requirements.
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References
1. Aghdassi, E., Wendland, B., Stapleton, M., Raman, M., & Allard, J. (2007). Adequacy of nutritional intake in
a Canadian population of patients with crohn’s disease. American Dietetic Association, 107(9), 1575-1578.
2. Carter M. J., Labo, A. J., & Travis S. P. L. (2004). Guidelines for the management of inflammatory bowel
disease in adults, British Society of Gastroenterology, 53, v1-v13.
3. Crohn’s and Colitis Foundation of Canada. (2009). Food For Thought. Toronto: Crohn’s and Colitis
Foundation of Canada.
4. Crohn’s and Colitis Foundation of Canada. (2001). Nutrition, Diet and Inflammatory Bowel Disease.
Toronto: Crohn’s and Colitis Foundation of Canada.
5. Hartman, C., Eliakim, R., & Shamir, R. (2009). Nutritional status and nutritional therapy in inflammatory
bowel disease. World Journal of Gastroenterology, 15(21), 2570-2578.
6. Jeejeebhoy, K. N. (2002). Clinical Nutrition: 6. Management of nutritional problems of patients with
crohn’s disease. Toronto: Canada Medical Association, 166(7), 913-918.
7. Lucendo, A., & De Rezendo, L. (2009). Importance of nutrition in inflammatory bowel disease. World
Journal of Gastroenterology, 15(17), 2081-2088.
8. Nelms, M., Sucher, K., & Long, S. (2007). Nutrition Therapy and Pathophysiology. Belmont, CA: Thomson
Brooks/Cole Co, 488-498.
9. Razack, R., &Seidner, D. (2007). Nutrition in inflammatory bowel disease. (2007). Current Opinion in
Gastroenterology, 24(4), 400-405.
10. Steinhart, H.A., & Cepo, J. (2008). Crohn’s and Colitis Diet Guide. Toronto: Robert Rose Inc, 8-24, 63-94.
Handout designed by Amanda Lachowitzer, Brooke Guedo and Leah Edmonds, College of
Pharmacy & Nutrition, University of Saskatchewan.
Funding for this project provided by the Interprofessional Health Collaborative of
Saskatchewan and the Saskatoon Health Region.
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