Copyright ©2009 The WJG Press and Baishideng.
World J Gastroenterol. May 7, 2009; 15(17): 2081-2088
Published online May 7, 2009. doi: 10.3748/wjg.15.2081
Table 1 Causes of malnutrition in IBD (modified from García-Manzanares et al[63])
Decrease in oral intakeRestrictive diets, therapeutic fasting
By the disease itself: diarrhea, abdominal pain, nausea and vomiting, etc
Alteration in taste: due to drugs, vitamin and mineral deficiencies, pro-inflammatory mediators
Anorexigenous effect of pro-inflammatory cytokines
Gastrointestinal lossesDiarrhea
Loss of mucus and electrolytes
Protein-losing enteropathy
Metabolic disordersIncrease in resting energy expenditure
Enhanced fat oxidation
Increase in nutritional requirementsInflammatory states
Increased basal oxidative metabolism
Infectious complications
Drug interactionCorticoids and calcium reabsorption
Corticoids and protein catabolism
Salazopirine and folates
Methotrexate and folates
Cholestyramine and liposoluble vitamins
Antimicrobials and vitamin K
Anti-secretors and iron
Poor absorption of nutrientsReduction of the absorptive surface: intestinal resection, enteric fistulas, hypertrophy of the villi
Blind loops, bacterial overgrowth
Poor absorption of bile salts in ileitis or resection