Introduction

Inflammatory bowel disease (IBD) significantly impacts patients’ nutritional status and quality of life. Nutritional deficiencies are common in IBD and can worsen disease progression.

Aims & Methods

The aim of this study is to assess the nutritional status of patients with IBD and explore its relationship with quality of life in this cohort. A cross-sectional study conducted at a specialized center assessed nutritional status using the MUST and MIRT tools. For pediatric patients, the "Strong Kids" screening tool was used. A multidisciplinary nutritional intervention was provided, followed by quality of life evaluation using the EQ-5D and IBDQ-32 instruments. Statistical analyses were performed to examine the association between nutritional status and quality of life.

Results

Among 90 IBD patients, 26.6% required hospitalization due to disease flare-ups, primarily adults and females. The median age was 36.7 years (range: 4–81, SD: 32.6), with 58.3% diagnosed with Crohn’s disease and 83.3% requiring biologic therapy (Table 1). The odds ratios (OR) for malnutrition in hospitalized patients were 8.33 (95% CI: 1.16–27) for ulcerative colitis and 25 (95% CI: 11.6–45.2) for Crohn’s disease. All hospitalized adults exhibited poor biochemical control and moderate-to-severe hypoalbuminemia; 25% had sarcopenia. Nutritional support was provided to 49% of patients within the past year. All severely ill hospitalized patients were malnourished.
Pediatric patients, all of whom received nutritional support, demonstrated a higher degree of nutritional compromise. Among these, 25% required parenteral nutrition, while 87.5% received enteral nutrition, primarily with high-calorie, high-protein formulas. During hospitalization, 87.5% gained weight and improved nutritionally, with 75% achieving normal nutritional status at three-month follow-up, although one patient died.
Following the nutritional intervention, over 80% of adults did not experience further nutritional deterioration. In the outpatient cohort, 20 patients were evaluated, of whom 30% were identified as high risk for malnutrition according to MUST, and 25% had nutritional risk (MIRT score ≥3). Patients with poorer initial nutritional status had significantly worse quality of life, with notable impairments in mobility (P = 0.2778; 95% CI: 2.03–64.1), self-care (P = 0.003; 95% CI: 9.45–90.5), daily activities (P = 0.1457; 95% CI: 1.14–58.2), pain/discomfort (P = 0.197; 95% CI: 0.53–53.3), and visual analog scale scores (P = 0.012; 95% CI: 22.9–88.4). Poor nutritional status was also associated with lower quality of life scores on the IBDQ-32 (P = 0.04; 95% CI: 10.3–60.7).

Conclusion

Nutritional status is a key component of IBD management, as malnutrition is linked to poorer quality of life. Screening tools such as MUST and MIRT in adults, and “Strong Kids” in children, are essential for early identification of at-risk patients. Pediatric patients tend to have more severe nutritional compromise than adults, and nutritional support during hospitalization contributes significantly to recovery.

References

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Disclosure

None declared