Perioperative nutrition in the setting of pediatric inflammatory bowel disease

Nutr Clin Pract. 2024 Feb;39(1):184-192. doi: 10.1002/ncp.11021. Epub 2023 Jun 11.


Jonathan Wong 1John Densmore 2Julia Hilbrands 3Abdul Elkadri 3Jose Cabrera 3Josh Noe 3Jens Eickhoff 4Praveen S Goday 5


Author information

1Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.

2Department of Surgery, Division of Pediatric Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

3Department of Clinical Nutrition, Children's Wisconsin, Milwaukee, Wisconsin.

4Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.

5Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA.


Background: Optimization of nutrition prior to inflammatory bowel disease (IBD)-related surgery could improve outcomes. The aim of this study was to assess the perioperative nutrition status and management of children undergoing intestinal resection for treatment of their IBD.

Methods: We identified all patients with IBD who underwent primary intestinal resection. We identified malnutrition using established criteria and methods of nutrition provision at various time points (preoperative outpatient evaluation, admission, and postoperative outpatient follow-up) for elective cases (who underwent their procedure at a scheduled admission) and urgent cases (who underwent an unplanned surgical intervention). We also recorded data on postsurgical complications.

Results: A total of 84 patients were identified in this single-center study (male sex: 40%, mean age: 14.5 years, Crohn's disease: 65%). Thirty-four patients (40%) had some degree of malnutrition. Prevalence of malnutrition in the urgent and elective cohorts was similar (48% vs 36%; P = 0.37). Of these patients, 29 (34%) were noted to be on some type of nutrition supplementation prior to surgery. Postoperatively, BMI z scores increased (-0.61 vs -0.42; P = 0.0008), but the percentage of patients who were malnourished did not change from preoperative status (40% vs 40%; P = 0.10). Despite this, use of nutrition supplementation was only noted in 15 (17%) patients at postoperative follow-up. Complications were not associated with nutrition status.

Conclusion: Utilization of supplemental nutrition decreased postprocedure despite no change in malnutrition prevalence. These findings support the development of a pediatric-specific perioperative nutrition protocol in the setting of IBD-related surgery.

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