IBD – diet and nutrition

IBD – diet and nutrition

October 12, 2019 0 By Ewald Bahringer


(upbeat music) So I support children and
young people with IBD. So if they are struggling to gain weight, maybe because of the disease
or because they’re not really feeling that great
and don’t really want to eat, I would help support them
from that point of view to see what we can do
to try to help them grow to the potential that
they should be getting. I also help them if they have to go onto liquid nutrition therapy
and support them through. We’ll see them in clinics to
make sure that they’re growing, get their weights, give
them extra support at home if they need it through telephone calls to make sure that they’re doing okay with the diet that they’re on as well. (upbeat music) Liquid nutrition therapy is
used to treat Crohn’s disease. It’s where the patient takes the nutrients that they need, so the
calories and the protein and the vitamins and minerals and this all comes in a liquid form. The dietitian will work
out how much they need to drink to make sure
that everything’s met and that they still grow. Patients tend to be on
it for six to eight weeks and they can’t have anything
else to eat or drink apart from tap water as well. No one really knows why it works, we just know it does work
in the majority of patients, about 80% of patients respond to it. It’s got no side effects. So it’s nicer than going on
to something like steroids, which is why we use it as a
first line treatment as well. Everywhere does it, there might be some discrepancies in different areas. When we do it, after your
eight weeks you go straight back on to your normal diet, straight away and hopefully your symptoms
have improved by that point. We do assess at about the
halfway point to see whether or not there is any improvement
with your bloods, stool samples and also looking at
your symptom scores as well. If they’ve all improved then you continue but if you haven’t quite
responded then we’ll take you off and normally look at different alternative treatment as well. (upbeat music) If someone’s going on to
liquid nutrition therapy it’s usually because they’ve just been diagnosed with Crohn’s disease. They probably would’ve
gone for their endoscopy, got their results back and
been told that they’ve got Crohn’s disease and
that needs to be treated and then they’ll be going on
to liquid nutrition therapy. Unfortunately it doesn’t
work in ulcerative colitis. They might also be going on
to it if they’ve responded really well in the past to
liquid nutrition therapy and they’ve just had a bit of a relapse. Then they might be going back on to it to try and get everything under control. (upbeat music) So if we’re seeing a
child with Crohn’s disease because they’re being treated
with liquid nutrition therapy, we tend to see them when
they’re on hospital ward. They tend to be there for
about three days or so while we get them built up on the volume. What they get from us
is that we’ll explain why they’re going on
liquid nutrition therapy, how we’re going to do it, what
happens when they get home, tips that they can do with the drinks that they’re having to
have, whether it’s making ice lollies with them,
some people try to make it in to ice cream as well
and then talking about how we can help them
with schools going on to liquid nutrition therapy and
trying to give them support to make sure that they can
definitely drink the volume that they need to have. If they’re coming in to clinic to see us because they’re not maybe
gaining weight how they need to gain weight or they’re
not really growing how we want them to grow,
then what would happen is they’ll come and see us, we’d probably take a weight and height. We would then also go through the diet, what they tend to eat on the average day to look to see if there’s
anything that we can do from a food point of view first of all to help get extra calories
in or if they’re struggling from that and there isn’t
really anything else we can do from a diet point of view then there’s often
special drinks or puddings that we can put them on to try and help with the weight
gain and the height as well. (upbeat music) I think it’s always a concern of parents, whether or not everyone’s
getting everything that they need and it is really really hard to ensure that patients get everything. We tend to look at the diet as a whole. So we’d be looking to see whether they are getting a balanced diet,
it’s important to make sure there is some protein sources going in, there’s some carbohydrate
sources, that there’s some vegetables and fruits to get your vitamins and minerals in as well, that
there’s some dairy going in to make sure you’re getting
calcium to help your bones stay strong when you’re growing. I think it’s making sure
that you get a little bit of all of that going in
but it’s also important to acknowledge that these are children and they are going to want to go out and have the occasional treat and that is absolutely fine to do. It’s just within moderation. If you’re really really
struggling to get everything in to the diet and you are concerned, then you can ask to see a dietitian and we can have a look and
help and see whether or not something like a multivitamin might help from that point of view as well. (upbeat music)