Crohn's disease and ulcerative colitis can affect food intake and lead to malabsorption of nutrients and intestinal bacterial overgrowth.
Malnutrition is prevalent among patients with inflammatory bowel disease (IBD). It affects about 18% to 62% of people with ulcerative colitis, and it is a significant cause of weight loss and poor clinical outcomes. Factors that contribute to malnutrition in individuals with IBD include reduced food intake, malabsorption of nutrients, intestinal bacterial overgrowth, and chronic blood and protein loss.
An observational study published last month in Alimentary Pharmacology and Therapeutics examined the trends in protein-calorie malnutrition among hospitalized patients with IBD and without IBD. The study, led by Anoushka Dua, M.D., from the David Geffen School of Medicine at UCLA in Los Angeles, also looked at the association between malnutrition and nutrition support and hospitalization outcomes.
Dua and his colleagues used data from the Nationwide Readmission Database from 2010 to 2018. Data were included for 1,216,033 patients with Crohn’s disease and 832,931 patients with ulcerative colitis. There were 1,820,023 hospitalizations among patients with Crohn’s disease and 1,089,853 among those with ulcerative colitis.
The researchers found that hospitalized patients with IBD were 2.9 to 3.1 times more likely to have protein-calorie malnutrition than hospitalized patients without IBD. In addition, IBD patients with malnutrition had an increased risk of readmission and mortality. They also had a longer length of stay and hospitalization costs.
Nutritional support, whether parenteral or enteral, was associated with a decreased risk of readmission. However, it was also linked to higher mortality and increased length of stay and hospitalization costs. The researchers indicate that patients who receive nutritional support are more ill and require longer hospital stays. This, then, increases hospitalization costs.
The authors conclude that malnutrition in hospitalized patients with IBD contributes significantly to readmission, mortality, length of stay, and healthcare costs. They suggest that the risk of readmission in patients with IBD could be reduced by providing nutrition support.