Systematic review of nutrition screening and assessment in inflammatory bowel disease

Li, Suqing; Ney, Michael; Eslamparast, Tannaz; Vandermeer, Ben; Ismond, Kathleen P.; Kroeker, Karen I.; Halloran, Brendan P.; Raman, Maitreyi

doi:10.3748/wjg.v25.i28.3823

Cited by 52 publications

(41 citation statements)

References 60 publications

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“…In addition, elevated nutritional requirements exist due to the metabolic cost of inflammation and mucosal tissue repair, and pharmacological therapy [ 7 ]. Consequently, malnutrition is routinely screened in IBD patients using a nutritional screening tools such as “MUST” (Malnutrition University Screening Tool), NRS (Nutritional Risk Screening)—2002, NRI (Nutritional Risk Index), MIRT (Malnutrition Inflammation Risk Tool), and the SaskIBD-NRT (Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool); evidence validating these in the use of IBD requires further research [ 28 ]. These traditional screening tools may place too much emphasis on body mass index (BMI) and weight loss, which are believed to be unreliable indicators of malnutrition in IBD patients [ 29 ].…”

Section: Assessment Of Sarcopeniamentioning

confidence: 99%

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

et al. 2021

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Malnutrition is a common condition encountered in patients with inflammatory bowel disease (IBD) and is often associated with sarcopenia (the reduction of muscle mass and strength) which is an ever-growing consideration in chronic diseases. Recent data suggest the prevalence of sarcopenia is 52% and 37% in Crohn’s disease and ulcerative colitis, respectively, however it is challenging to fully appreciate the prevalence of sarcopenia in IBD. Sarcopenia is an important consideration in the management of IBD, including the impact on quality of life, prognostication, and treatment such as surgical interventions, biologics and immunomodulators. There is evolving research in many chronic inflammatory states, such as chronic liver disease and rheumatoid arthritis, whereby interventions have begun to be developed to counteract sarcopenia. The purpose of this review is to evaluate the current literature regarding the impact of sarcopenia in the management of IBD, from mechanistic drivers through to assessment and management.

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Section: Assessment Of Sarcopeniamentioning

confidence: 99%

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

et al. 2021

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“…Regarding malnutrition screening tools, NRS-2002, MUST, MST as well as IBD-specific tests (MIRT, SaskIBD-NR) are currently the most commonly used in the IBD population [30]. In our cohort, the sensitivity of these nutritional screening tools was not high (50-82%) if compared with GLIM.…”

Section: Discussionmentioning

confidence: 65%

GLIM Criteria for Malnutrition in Surgical IBD Patients: A Pilot Study

et al. 2020

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Background: A gold standard method for malnutrition diagnosis is still lacking in Inflammatory Bowel Disease (IBD). Objective: The aims of this study are to determine the prevalence of malnutrition in IBD patients according with recently published Global Leadership Initiative on Malnutrition (GLIM) criteria, to detect the factors contributing to the onset of malnutrition, and to evaluate the most accurate predictor of malnutrition risk within the available nutritional screening tools. Methods: Fifty-three consecutive adult IBD patients [38 Crohn’s disease (CD) and 15 ulcerative colitis (UC)] had been assessed preoperatively by a multidisciplinary IBD team before undergoing elective surgery. Several malnutrition risk tools were tested, such as NRS-2002, MUST, MST, MIRT, and SaskIBD-NR. The statistical association of independent GLIM variables with baseline characteristics of patients was explored as well as the concordance with the European Society for Clinical Nutrition and Metabolism (ESPEN 2015) and the screening tools. Results: Twenty-two IBD patients (42%) were malnourished according to GLIM criteria, of which 13 were CD (34%) and 9 UC (60%). The etiological criteria of inflammation and reduction of food intake were present in 51% and 19% of our patients, respectively. The prevalence of GLIM phenotypic criteria was 28%, 28% and 34% for BMI, Free Fat Mass Index (FFMI) and unintended weight loss (UWL), respectively. The presence of ileostomy was statistically associated with a higher prevalence of BMI (p = 0.030), FFMI (p = 0.030) and UWL (p = 0.002) values lower than the GLIM criteria cut-offs, while secondary surgery is associated with a decrease in FFMI (p = 0.017) and UWL (p = 0.041). The sensitivity of the tested nutritional screening tools, compared with the GLIM prevalence of malnutrition, was not satisfactory (between 50 and 82%). Conclusions: GLIM has a higher rate of malnutrition detection than ESPEN 2015, as malnutrition in IBD seems linked to inflammation and secondary malabsorption even without a reduction of food intake. The sensitivity of the screening tools is lower than the specificity when compared with GLIM criteria for malnutrition diagnosis.

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“…Moreover, IBD is a risk factor for deficiency of iron, calcium, selenium, zinc and fat‐soluble vitamins, which translates into increased complications of poor wound healing in this population 43 . These findings suggest that providers screen their patients with IBD for malnutrition before pursing bariatric procedures that may require development of specific questionnaires as those used for the general population are not reliable for the IBD population 44 …”

Section: Discussionmentioning

confidence: 99%

Safety of bariatric surgery in patients with inflammatory bowel disease: A systematic review and meta‐analysis

et al. 2020

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Summary The efficacy of bariatric surgery in achieving weight loss and preventing long‐term comorbidities such as cardiovascular diseases, diabetes mellitus and osteoarthritis is well established. Data regarding safety of bariatric surgery in patients with inflammatory bowel disease (IBD) is scarce. We attempted a systematic review and meta‐analysis to evaluate the complications following bariatric surgery in patients with IBD. The primary outcomes evaluated were wound infection, Clavien‐Dindo grade > II complications and IBD exacerbation (within 1 year). Secondary outcomes evaluated included overall mortality, stricture, small bowel obstruction, acute kidney injury (AKI) and thromboembolism. Pooled outcomes (event rate) with 95% confidence interval (CI) were calculated using random effects model. A total of 14 studies (all observational) with 2608 patients were included. The rates of primary outcomes were: wound infection (4.1%, 95% CI: 0.9‐7.2), Clavien‐Dindo grade > II complications (2.0%, 95%: CI 0.6‐3.5) and IBD exacerbation (4.3%, 95% CI: 0.7‐7.9). The pooled rate for other outcomes was: mortality 0.1%, stricture 6.5%, small bowel obstruction 6.7%, AKI 2.2% and thromboembolism 0.1%. Bariatric surgery is relatively safe in patients with IBD and should be pursued to reduce comorbidities associated with obesity. Future comparative studies are needed to further assess the safety of bariatric surgery in population with and without IBD.

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Systematic review of nutrition screening and assessment in inflammatory bowel disease

Cited by 52 publications

References 60 publications

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

GLIM Criteria for Malnutrition in Surgical IBD Patients: A Pilot Study

Safety of bariatric surgery in patients with inflammatory bowel disease: A systematic review and meta‐analysis

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