Inflammatory%20bowel%20disease Patient Education
Patient Education
- Audiovisual or suitable written information on IBD should be given
- Stress the importance of adherence to therapy
- Educate and support patient to encourage treatment compliance
- Avoid use of NSAIDs which can exacerbate disease activity
Lifestyle Modification
Nutrition and Lifestyle Modification
Ulcerative Colitis
- Cessation of smoking may prevent flaring of symptoms in patients with UC
- Stress management programs may aid in the patient's overall disease outlook
- Patients are prone to malnutrition and may suffer detrimental effects from it
- Decrease fiber intake during increased disease activity to reduce frequency of bowel movements
- High-fiber diets to be given only for those with involvement limited to the rectum
- Protein intake should be increased to 1.2-1.5 g/kg/day in adults during active IBD
- Nutritional support is adjunctive in patients who are malnourished or have a difficult time maintaining normal nutritional status and should also be considered in those with intestinal partial obstruction awaiting surgery1
- Prebiotics and probiotics have no clear evidence on its role as adjunctive therapy
- Routine multivitamin supplementation for all patients
- Routine vitamin D and calcium supplementation for those under steroid therapy
- Iron supplementation, either oral or parenteral, for those with chronic iron deficiency
Crohn's Disease
- Smoking cessation should be strongly advised
- Stress management programs may aid in the patient's overall disease outlook
- Patients are prone to malnutrition and may suffer detrimental effects from it
- Decrease fiber intake during increased disease activity to reduce frequency of bowel movements
- Placing the patient on NPO, or giving only liquid diet or pre-digested formula may decrease obstructive symptoms
- Protein intake should be increased to 1.2-1.5 g/kg/day in adults during active IBD
- Elemental or polymeric diets may be used to induce remission in some patients with active CD who have contraindications to corticosteroids or where patients prefer to avoid corticosteroids
- May reduce inflammatory features of active CD; although, long-term course of the disease is not altered
- Cost and compliance may be a limiting factor
- May be attempted as adjunctive therapy to support patient’s nutrition
- May reduce inflammatory features of active CD; although, long-term course of the disease is not altered
- Exclusive enteral nutrition is used as disease-modifying therapy for growth failure1
- Usually given for 3-6 weeks
- Nutritional support is adjunctive in patients who are malnourished or have a difficult time maintaining normal nutritional status and should also be considered in those with intestinal partial obstruction awaiting surgery1
- Avoid use of NSAIDs which can exacerbate disease activity
- Prebiotics and probiotics have no clear evidence on its role as adjunctive therapy
- Routine multivitamin supplementation for all patients
- Routine vitamin D and calcium supplementation for those under steroid therapy
- Iron supplementation, either oral or parenteral, for those with chronic iron deficiency
- Vitamin B12 supplementation for deficiency states at 1000 mcg SC every month
1Various enteral nutritional products are available. Please see the latest MIMS for specific formulations and prescribing information.