Inflammatory%20bowel%20disease 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

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
• 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.