Perioperative Dietary Therapy Beneficial in IBD

By Reuters Staff

October 11, 2019

NEW YORK (Reuters Health) - People with inflammatory bowel disease (IBD) who undergo surgery fare better if they receive perioperative dietary therapy, according to a new research review.

Nearly half of Crohn's disease patients and 16% of ulcerative colitis patients will undergo surgery at least once in their lives, Dr. Michel Adamina of the University of Basel in Switzerland and colleagues write in the Journal of Crohn's and Colitis, online September 24.

"Patients are frequently referred to surgery malnourished and acutely unwell owing to a prolonged course of disease," they add. While improving patients' nutritional status results in better outcomes, "attempts at developing nutritional guidelines have been hampered by a lack of high-quality evidence, particularly from randomized controlled trials (RCTs)."

To address the issue, the European Crohn's and Colitis Organisation convened a panel of 16 IBD experts including Dr. Adamina to develop practice recommendations for perioperative dietary therapy in IBD.

Their report includes 26 practice positions regarding IBD patients' perioperative and long-term needs, many of which emphasize the importance of multidisciplinary teams.

The article also addresses routine screening; using oral, enteral and parenteral nutrition to optimize perioperative nutrition; the role of dietary fiber and supplements, and nutritional management of patients with restorative proctocolectomy, an ostomy, strictures, or short-bowel syndrome.

"The integration of perioperative nutritional screening and ad hoc dietary therapy has the potential to improve quality of care and patient-reported outcomes," Dr. Adamina and colleagues write. "Simple interventions such as iron-deficiency screening and supplementation are useful in reducing the need for transfusion and improving recovery rates and quality of life. In addition, preoperative carbohydrate loading and early feeding have become an integral part of enhanced recovery pathways in gastrointestinal surgery."

Dr. Adamina was not available for an interview by press time.


J Crohns Colitis 2019.