scholarly journals Prevalence of Malnutrition, Its Risk Factors, and the Use of Nutrition Support in Patients with Inflammatory Bowel Disease

Author(s):  
Jing Liu ◽  
Xiaolong Ge ◽  
Chunhui Ouyang ◽  
Dongxu Wang ◽  
Xiaoqi Zhang ◽  
...  

Abstract Background Malnutrition is prevalent among patients with inflammatory bowel disease (IBD). Nutritional profiles among Asian patients with IBD have seldom been investigated. We assessed the prevalence of and risk factors for malnutrition, use of nutrition support, and sociopsychological status associated with malnutrition among patients with IBD in China. Methods Patients with ulcerative colitis (UC) and Crohn’s disease (CD) recruited from 43 tertiary referral hospitals were screened for malnutrition and nutrient deficiencies in this cross-sectional study. The use of nutrition support was recorded. The sociopsychological status was assessed by subjective questionnaires. Factors associated with malnutrition were analyzed, and multivariate regression was used to determine independent predictors for malnutrition. Results We recruited 1013 patients with a median age of 35.0 years, 58.5% of them had CD, and 61.4% of all patients were male. Overall, 49.5% (501) of patients were diagnosed with malnutrition, including 57.0% of patients with CD, 38.8% of patients with UC, and 44.1% of patients with quiescent or mildly active disease. Nutrient deficiencies were prevalent despite the absence of malnutrition. Malnutrition was associated with adverse sociopsychological status, including decreased social support, higher perceived stress, and impaired quality of life. Moderate to severe disease activity and extensive disease were two independent risk factors for malnutrition. In total, 41.6% of patients received nutrition support, and patients with risk factors were more likely to receive nutrition support. Conclusions Malnutrition was highly prevalent and associated with adverse consequences in Chinese patients with IBD. Malnutrition screening and early initiation of nutrition support are essential components in IBD care.

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S269-S270
Author(s):  
A Hassine ◽  
A Hammami ◽  
A Braham ◽  
H Jaziri ◽  
A Jmaa

Abstract Background Fatigue is one of the most common symptoms reported by patients with chronic inflammatory bowel disease (IBD), being in flare or in remission. Thus, several fatigue measurement tools have been developed. The objective of our work was to assess the prevalence of fatigue in patients with IBD and its impact on daily life, and to determine its risk factors. Methods This is a cross-sectional study of patients followed for IBD who presented to our consultation during the three months preceding the study. Fatigue assessment was performed by IBD-F score (The Inflammatory Bowel Disease Fatigue Self-assessment Scale). The higher the score, the more disabling the fatigue. The activity of Crohn’s disease (CD) was assessed by the Harvey-Bradshaw index (HBI), that of ulcerative colitis (UC) by the clinical Mayo score. Results One hundred patients were included. Thirty-two patients (32%) had UC and 68 patients (68%) had CD. The mean age was 42.18 years [16–81 years], with a predominance of men (sex ratio = 1.5). Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Extra-intestinal manifestations, particularly articular, were noted in 20% of cases. 36% of patients were in clinical remission. The prevalence of fatigue was 94.11% in MC and 93.75% in RCH. Fatigue was noted in 83.3% of patients in remission.Fatigue was severe (section I score between 11 and 20) in 40% of patients. We found a significant association and a linear correlation between the presence and severity of fatigue and CD activity (p <0.001, r = 0.84), as well as UC activity (p <0.001, r = 0.74). A significant association was found with extra-intestinal manifestations (p = 0.028), as well as with the presence of other chronic diseases (p = 0.014). In 30% of cases, fatigue was responsible for a functional handicap (section II score between 61 and 120). This effect was also strongly correlated with disease activity: MC (p <0.001, r = 0.74) and RCH (p <0.001, r = 0.73). Conclusion Assessing the severity of fatigue and its impact on the daily activities of patients is a crucial pillar in the management of patients with IBD. In our series, the prevalence of fatigue was 94%. It was associated and correlated with the degree of disease activity.


2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Robert J Ulrich ◽  
Jonathan Bott ◽  
Hannah Imlay ◽  
Kerri Lopez ◽  
Sandro Cinti ◽  
...  

Clostridioides difficile enteritis (CDE) after colectomy is an understudied infectious syndrome. We reviewed 20 years of post-colectomy data and found CDE in 44/855 (5.1%) patients, usually within one year of surgery. Risk factors include acid suppression, inflammatory bowel disease, and antibiotics with enteral feeds. Clostridioides difficile enteritis often presents with severe disease requiring hospitalization.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S266-S266
Author(s):  
A Hassine ◽  
A Hammami ◽  
W Ben Ameur ◽  
W Dahmani ◽  
N Elleuch ◽  
...  

Abstract Background Sexual dysfunction is often associated with impaired body image and quality of life in patients. However, little data exists on sexual dysfunction (SD) in patients with Chronic Inflammatory Bowel Disease (IBD). The aim of this study was to assess the prevalence and risk factors for sexual dysfunction in patients with IBD. Methods This is a cross-sectional study of all patients followed for IBD. Sexual function was assessed by the Female Sexual Index Function (FSIF) for women and the International Index of Erectile Function (IIEF) for men. Sexual dysfunction was confirmed when the total FSIF score was less than 26, or the IIEF score less than 26. Crohn’s disease (CD) activity was assessed by the Harvey-Bradshaw index (HBI), and that of ulcerative colitis (UC), by the clinical Mayo scores. Results We collected 100 patients, with a mean age of 42.18 ± 15.71 and a sex ratio (M / F) = 1.5. Sixty eight patients had CD and 32 patients had UC. Ano-perineal manifestations were present in 38.2% of cases. Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Twelve patients had proctitis. 38% of patients had surgical treatment: 18.75% for patients with UC and 47.05% for those with CD. Total colectomy was performed in 12% of cases. At the time of the study, 20% of patients were on systemic corticosteroid therapy, 22% on Azathioprine, 4% on Salazopyrine, 8% on 5-ASA and 46% on Anti-TNFα. Sexual dysfunction was reported by 42.9% of women: 57.14% (UC) vs 38.46% (CD) (p = 0.042). On the other hand, sexual dysfunction was reported by 27.6% of men: 22.2% of men with UC and 28.57% with CD, with no statistically significant difference (p = 0.78). A significant association was found between sexual dysfunction and the degree of disease activity (p <0.001 for CD, p = 0.003 for UC), as well as pancolitic involvement in women with UC (p = 0.002). However, the presence of anoperineal manifestations, rectal involvement and history of surgery were not significantly associated with the frequency of sexual disturbances. Conclusion Our study showed a high prevalence of sexual dysfunction in patients with IBD. Training gastroenterologists in the management of sexual dysfunction would make it possible to satisfy patient expectations.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S546-S547
Author(s):  
J S Lasa ◽  
A Sambuelli ◽  
I Zubiaurre ◽  
G J Correa ◽  
P Lubrano ◽  
...  

Abstract Background Evidence on the adoption of different pharmacologic strategies in inflammatory bowel disease (IBD) in the real-world setting in Latin America is scarce. Herein, we describe the clinical characteristics and therapeutic strategies of IBD patients (pts) in Argentina. Methods RISE AR (NCT03488030) was a multicentre, non-interventional study with a cross-sectional evaluation and a 3-year retrospective data collection period conducted in Argentina (12/2018-05/2019) to assess the use of IBD treatments. Adult pts (≥18 years old) with a previous diagnosis of moderate-to-severe ulcerative colitis (UC) or Crohn′s disease (CD) based on clinical, endoscopic or imaging criteria at least 6 months prior to enrolment, were included. Results Overall, 101 CD and 145 UC pts were included. Median (range) age (years) at enrolment was 39.5 (18.2–74.0) for CD (51.2% female) and 41.9 (18.0–80.4) for UC (55.2% female); median (range) disease duration (years) was 7.4 (0.6–36.9) for CD and 5 (0.7–33.8) for UC. At enrolment, 51.5% of CD pts had colonic involvement, 32.7% ileocolonic, 8.9% ileal, 1% isolated upper tract and 5.9% had combined L4/other. In UC, 46.2% had extensive colitis, 44.7% left-sided colitis and proctitis 9.1%. 51.6% of CD pts had non-inflammatory behaviour (37.7% stricturing; 13.9% penetrating), and 34% had perianal disease (13.9% as B1p), resulting in a total of 65.5% pts with complicated disease. Only 9.3% of CD (Harvey Bradshaw Index ≥8) and 7.7% of UC (partial Mayo Score ≥5) pts showed moderate-to-severe disease activity at enrolment. In CD, 70.3% of pts were receiving a biologic agent vs. 29.7% of UC pts. Immunosuppressant (IMM) use was similar between groups (CD 39.6%, UC 40.0%); nearly one-third of the pts on a biologic were receiving concomitant IMM (CD 33.8%, UC 34.9%). Aminosalicylates (5-ASA) were used for most UC pts (89.0%) vs. 47.5% of CD pts, mainly in those with L2 disease. 5-ASA monotherapy was prescribed in 32.1% of UC vs. 5.3% of CD pts, but were also used with IMM (UC 25%, CD 11%), biologics (UC 15%, CD 11.6%) or all three therapies combined (UC 6.4%, CD 17.9%). Corticosteroids (CS) were the least prescribed therapy (CD 7.9%, UC 13.8%). IBD treatments ever prescribed during the retrospective period were (CD, UC): biologics: 79.2%, 33.8%; IMM: 65.3%, 58.6%; 5-ASA: 62.4%, 97.9%; CS: 55.4%, 69.7%. Conclusion In this cohort of IBD patients, biologics use was high, especially among CD patients, in line with disease behaviour, and possibly by their increased availability in these reference centres. This study also highlights country-specific clinical features such as the low proportion of CD pts and the high prevalence of colonic involvement in CD.


2015 ◽  
Vol 34 (6) ◽  
pp. 1202-1209 ◽  
Author(s):  
Yasuyo Wada ◽  
Tadakazu Hisamatsu ◽  
Makoto Naganuma ◽  
Katsuyoshi Matsuoka ◽  
Susumu Okamoto ◽  
...  

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S204-S205
Author(s):  
L Martins Figueiredo ◽  
F Correia ◽  
M A Rafael ◽  
L Lourenço ◽  
A M Oliveira ◽  
...  

Abstract Background The real impact of COVID-19 infection on patients with Inflammatory Bowel Disease (IBD) is unknown. It was speculated that this population could be a risk group. The aim of this study is to evaluate the incidence of SARS-CoV2 infection, the impact of initiation/change of IBD therapy and its morbidity and mortality, during the COVID-19 pandemic in Portugal. Methods Prospective cross-sectional study. Patients with IBD followed at a Gastroenterology Department in an area with a high incidence rate of SARS-CoV2 were included, from 01/03/2020 to 31/08/2020. Data was obtained through telephonic appointments, hospital inpatients admissions, Emergency Department Service and Day Hospital episodes. Results 335 patients were included, 194 female, with a mean age of 47.4 years (18–88). 200 had Crohn’s disease (CD), 132 Ulcerative Colitis, 3 unclassified colitis. 320 were on therapy (95.5%): salicylates n=230 (71.9%), systemic corticosteroids n=34 (10.6%) (18 started during the pandemic), thiopurines/methotrexate n=117 (36.6%) (8 started in this period), biological n=148 (46.3%) (14 started in this period). 7 patients (2.2%) triple immunosuppressed. 75 patients had disease in remission, 232 mild/moderate, 28 severe disease (requiring hospitalization). SARS-CoV2 infection was observed in 3 patients (incidence rate: 0.89%), treated as an outpatient basis. 2 male, mean age 58 years, 2 with CD. Comorbidities: 0: n = 1; 2: n = 1; 4: n = 1. 2 patients were on salicylates and one on adalimumab (monotherapy, before the pandemic). There were no deaths. Conclusion All patients started or maintained their IBD therapy according to current international guidelines. A significantly higher incidence of COVID-19 infection than that of the local and Portuguese population in general has not been documented. According to our preliminary results, the population with IBD does not appear to be a risk group for acquiring infection or having a severe course of the disease.


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