Inflammatory bowel disease: test for malnutrition risk
Acute nutritional problems for one in 5 patients can jeopardise their health in the case of Crohn's disease or ulcerative colitis: today it is possible to make an initial self-assessment and then refer to the specialist
by Salvo Leone *
In chronic inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis, nutrition continues to be one of the most neglected aspects of care. Yet, the data tell us that it represents a fundamental element for people's quality of life and for the effectiveness of treatment itself. A new national survey promoted by Amici Italia on more than 3,000 Italian patients with Mici photographs a situation that we can no longer ignore: almost 75% of people state that they have never received a malnutrition risk assessment from a health professional, or that they do not remember it.
50,000 patients at risk
The survey, carried out using the international Must (Malnutrition Universal Screening Tool) protocol, involved 3,114 people suffering mainly from ulcerative colitis and Crohn's disease. The results show that about one in five patients is already at high or acute nutritional risk. If we project this figure onto the estimated 250,000 patients in Italia, we are talking about a potential audience of about 50,000 people. Not only that. Almost 28.4% of the sample have a body mass index of less than 20, a threshold that may represent an important alarm bell for nutritional fragility. Moreover, more than 11% of the participants report significant unintentional weight loss in the last six months, while about 10% are in an acute phase of illness or in a condition that impairs eating for several consecutive days.
What fears
Malnutrition in Mici does not only mean weight loss. It also means deficiencies in essential micronutrients, reduced muscle mass, increased physical vulnerability and reduced ability of the body to cope. In many cases the patient tends to eat less for fear of symptoms, abdominal pain or diarrhoea, progressively entering a spiral of nutritional deterioration.
The National Campaign
For this reason, on the occasion of World Mici Day on 19 May, AMICI Italia decided to launch the national campaign 'Lose weight? Don't waste time!", realised with the patronage of the Italian Society of Artificial Nutrition and Metabolism (Sinpe) and the non-binding contribution of Lion Health. The aim is simple but fundamental: to raise awareness about the risk of malnutrition and encourage earlier screening. On AMICI Italia's website (www.amiciitalia.net) the MUST test is available free of charge, an internationally validated tool that, through a few questions, allows patients to carry out an initial self-assessment of their nutritional risk to be shared with the specialist doctor.
The campaign also includes a roadmap of territorial events in the main Italian MICI centres, information materials in clinics and online educational content with clinical nutrition specialists.
