Mitigating the Risk of Malnutrition & Hospitalization

Dietitian Lindsay Boisvenue teaches newly diagnosed patients about basic nutrition and how it can apply to IBD.
Dietitian Lindsay Boisvenue teaches newly diagnosed patients about basic nutrition and how it can apply to IBD.

People with inflammatory bowel disease (IBD) face a triple threat when it comes to nutrition.

Because the lining of their digestive tract is inflamed and not functioning properly, they may not absorb nutrients from their food properly. They may also limit their intake of food, due to lack of appetite and fear of the pain that often comes with eating. And, they may lose a lot of the food they have eaten to vomiting and diarrhea.

“Patients can become severely malnourished and dehydrated to the point they need to be hospitalized,” said Lindsay Boisvenue, a registered dietitian working with patients in the Nova Scotia Collaborative Inflammatory Bowel Diseases program. “They also face a high risk of developing eating disorders, anxiety and depression.”

There is currently no validated tool for screening IBD patients for nutrition risk, but Boisvenue aims to change this.

“We’re working on a simple screening questionnaire clinicians can use to quickly identify when patients are tipping into malnutrition risk,” she said. “If we can flag these patients early, we can work with them more intensively to correct their diets and supplement as necessary to restore their body mass and nutrient status.”

With Dr. Jennifer Jones,  Boisvenue has applied for funding to conduct a study to validate the screening tool. If proven effective, the tool would become part of standard practice in Nova Scotia and, Boisvenue hopes, Canada-wide. At the same time, Boisvenue has embarked on a collaboration with colleagues in Saskatchewan and British Columbia to test the effect of the Mediterranean diet on disease activity, gut microbiome composition and immune responses of patients with ulcerative colitis.

“I will be recruiting patients in our clinics to take part in the study and providing them with information about how to follow the Mediterranean diet,” said Boisvenue, noting that this is a diet rich in vegetables, fish and olive oil. “We’ll collect blood and stool samples for analysis and monitor their symptoms to gain a sense of the impact of the diet over time.”

Boisvenue constantly scans the literature for the latest evidence about the impact of specific foods, nutrients and special diets on IBD. She has completed a review of micronutrient status in IBD that she and Dr. Jones aim to publish, and recently developed “Nutrition 101: IBD,” a group education class for newly diagnosed patients.

This reviews the basics of nutrition in IBD and such topics as probiotics, omega-3 fatty acids, fibre, and special diets like FODMAPs, IBD-AID and the Specific Carbohydrate Diet (SCD).