Malnutrition and Quality of Life Among Adult Inflammatory Bowel Disease Patients

H Open. 2019 Nov 14;4(3):454-460. doi: 10.1002/jgh3.12278. eCollection 2020 Jun.

Jessica Pulley 1, Alwyn Todd 1 2 3, Christopher Flatley 3, Jakob Begun 3 4 5


Author information

1Department of Nutrition and Dietetics Mater Health Services Brisbane Queensland Australia.

2Menzies Health Institute Griffith University Gold Coast Queensland Australia.

3Mater Research Institute The University of Queensland Brisbane Queensland Australia.

4Department of Gastroenterology Mater Health Services Brisbane Queensland Australia.

5Translational Research Institute Brisbane Queensland Australia.

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Background and aim: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions of the gut resulting in a significant risk for malnutrition. The reported prevalence of malnutrition in inflammatory disease patients varies from 5.7 to 82.8%. The aim of this study was to measure the prevalence of malnutrition and its association with quality of life (QOL) in a cohort of Australian IBD outpatients.

Methods: A total of 107 consecutive patients (68 Crohn's disease, 35 ulcerative colitis, 4 indeterminate colitis) were enrolled in this cross-sectional study. Demographic data were collected, and patients underwent a malnutrition assessment using the patient-generated subjective global assessment. The RAND 36-item health survey was used to measure QOL.

Results: Mild to moderate malnutrition was detected in 17 patients (16%). Malnourished patients were more likely to be underweight (P ≤ 0.01), have active disease (P ≤ 0.01), and have been admitted to hospital in the preceding 12 months (P ≤ 0.05). Malnourished patients had a significantly lower QOL in physical (P ≤ 0.01) and mental (P ≤ 0.01) health components. Patients with active or recently active disease had reduced QOL compared to patients in remission. Malnutrition factors predictive of poor physical health-related QOL were pain (odds ratio [OR] = 12.8, 95% confidence interval [CI] 2.0-80.4) and unintentional weight loss (OR = 3.1 per kg lost, 95% CI 1.2-7.9). The predictor of poor mental health-related QOL was early satiety (OR = 7.7, 95% CI 1.7-33.9).

Conclusions: The malnutrition prevalence for this population was 16%. Malnutrition was associated with being underweight, active disease, and increased number of hospital admissions. Disease activity and malnutrition were associated with poorer QOL.

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