Background Malnutrition is a frequent problem in inflammatory bowel disease (IBD) due to the increase in caloric consumption because of the pathology itself and due to the reduced intake. This low intake is mainly caused by the symptoms and the anorexia associated with the disease, but it is more and more common for patients to adopt elimination diets. Our aim was to investigate the general ideas about nutrition in patients with IBD, as well as to determine whether they consider that health professionals value the nutritional aspect. Methods Inclusion of patients with an established diagnosis of IBD followed-up in the unit of the Hospital Universitario La Paz, using an anonymised survey for the researcher and for the attending physician. Results A total of 118 patients were included, of which 56% (65 patients) were women. The mean age of the patients was 48.84 years (SD 14.2). All patients had a previous diagnosis of IBD: 51.7% (61 patients) ulcerative colitis (UC), 45% (53 patients) Crohn’s disease (CD) and 3.3% (4 patients) undetermined colitis. 55.6% (64 patients) believed that nutrition influenced the course of their IBD. The patients who answered yes were on average younger (44.5 vs. 53.9 years), these differences being statistically significant (p = 0.0003). Only 22 of the 64 patients (34.4%) believed that it was caused by a specific food or food group and the most frequent answer was food rich in fats, dairy products, alcohol or spices. 52.1% of the sample (61 patients) had eliminated some food from the diet since the diagnosis of IBD. The most noteworthy was the avoiding of dairy products (37%), fibre in 28% (most of them reducing the intake of fruits and vegetables), alcoholic drinks (17%) and carbonated drinks (11.5%). No statistically significant differences were found in the elimination of food from the diet according to age, sex or type of IBD. No differences were observed in the elimination of dairy products, carbonated drinks or alcoholic beverages depending on the type of IBD, being more frequent the elimination of fibre in patients with UC (7/10 patients) than in CD. Regarding the role of their attending physician, 77.5% (86 patients) thought that nutrition was important for their doctor and/or nurse dedicated to IBD, although only 52.6% (61 patients) believed they had received enough information for their pathology. Conclusion The health professionals dedicated to IBD should increase our efforts to properly inform patients about nutritional aspects, since in our experience more than a half of patients avoid one or more foods (without scientific evidence to support it). Furthermore, only 52.6% consider that they receive sufficient information regarding this matter.
Background Vedolizumab is a monoclonal antibody that binds to an integrin resulting in gut-selective anti-inflammatory activity. It is indicated for the treatment of inflammatory bowel disease (IBD), both in Crohn’s disease (CD) and ulcerative colitis (UC), but no benefit has been proved on inflammatory joint disease. The aim of this study was to analyse the incidence of the debut of inflammatory joint disease and also analyse the prevalence of outbreak of the previously known joint disease in IBD patients during treatment with vedolizumab. Methods Descriptive observational study of a prospective cohort of IBD patients treated with vedolizumab. All patients met the following inclusion criteria: adults > 18 years, histological diagnosis of CD or UC and having received or being currently being treated with vedolizumab. Demographic, clinical and analytical information were obtained from the Hospital’s database from both Gastroenterology and Rheumatology clinical records. Results A total of 44 patients (25 with CD and 19 with UC) were included. Of these, most had been pretreated with anti-TNF (41 switchers and 3 patients näive to biological therapy). The mean age of the included patients was 50 ± 15.4 years with predominantly female (54%). The mean follow-up time of patients in this study was 26 ± 10 months. In total, 13 patients (30%) presented joint symptoms during treatment with vedolizumab (8 with EC and 9 with UC). Of these 13 patients, 3 already had previous diagnosis of inflammatory joint pathology (spondyloarthritis), 6 patients debuted with inflammatory joint symptoms during treatment with vedolizumab and 4 mechanical arthralgias. Of the 6 patients with debut of inflammatory profile symptoms, inflammatory pathology was confirmed in 5 patients (spondyloarthritis) and 1 patient presented osteomuscular mechanical pathology. A total of 11 patients with the diagnosed rheumatological disease (25%) were observed in this cohort. Conclusion The incidence of inflammatory joint pathology in IBD patients treated with vedolizumab is similar to the one described in other cohorts regardless of the treatment received. Suspension of anti-TNF treatment to switch to vedolizumab may be associated with outbreaks of rheumatic disease. This presents a new challenge in the therapeutic approach, being crucial a multidisciplinary approach.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.