Current practice in relation to nutritional assessment and dietary management of enteral nutrition in adults with Crohn's disease

M. C. E. Lomer*, R. Gourgey, K. Whelan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

Background
Nutritional assessment and dietary intervention, particularly enteral nutrition, are important in the management of Crohn's disease (CD). National audits have reported that dietetic resourcing in gastroenterology is inadequate. The present study aimed to identify current practice in the nutritional assessment and dietary management of enteral nutrition in CD, as well as investigate the factors that influenced it.

Methods
A nationwide questionnaire survey adopting complete population sampling of all 296 UK acute hospitals was undertaken aiming to determine dietetic resourcing for gastroenterology. In addition, the case-note review method was used to investigate approaches to nutritional assessment and dietary management of enteral nutrition as treatment for active CD.

Results
Data were returned from 149 (56%) hospitals, providing assessment and management information on 190 patients. The median number of dietetic sessions dedicated to gastroenterology was 2 per week (interquartile range 4). Hospitals with five or more sessions per week dedicated to gastroenterology used a greater number of components in their nutritional assessment [mean (SD) 21.5 ( 5.0)] than those with fewer sessions [mean (SD) 19.6 (SD) 6.1, P=0.05]. Enteral nutrition was perceived to be effective in 100 (55%) of 182 patients. The major reasons for limited success were poor compliance and inadequate volumes consumed, as well as insufficient treatment duration.

Conclusions
The components included in a nutritional assessment of CD patients are significantly lower in hospitals with fewer dietetic gastroenterology sessions. Focus on improving compliance and duration of enteral nutrition is urgently required to maximise the success of enteral nutrition in the treatment of CD.

Original languageEnglish
Pages (from-to)28-35
Number of pages8
JournalJournal of human nutrition and dietetics : the official journal of the British Dietetic Association
Volume27
Issue numbers2
Early online date13 Jun 2013
DOIs
Publication statusPublished - Apr 2014

Keywords

  • Crohn's disease
  • dietary management
  • enteral nutrition
  • nutritional assessment
  • INFLAMMATORY-BOWEL-DISEASE
  • CARE PROCESS
  • DIETITIANS
  • STANDARDS
  • REMISSION

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