Q. Causes of Malnutrition in Inflammatory Bowel Disease?

The causes of malnutrition include:

• Decreased oral intake, which can be disease induced due to abdominal pain, diarrhoea, nausea, anorexia.

• Malabsorption due to decreased absorptive surface (destruction of villi), bile salt deficiency, bacterial overgrowth and use of drugs.

• Increased secretion and nutrient losses due to GI blood losses, electrolyte, trace mineral losses.

• Increased requirements due to inflammation, fever, increased intestinal cell turnover, haemolysis.

• Drugs interference related to corticosteroids, (interferes in calcium absorption and protein metabolism), sulfasalazine (interferes in folate absorption), Cholestyramine (interferes in fat soluble vitamin absorption).

• Deficiency of folate, vitamins A, C, D, low serum levels of zinc, copper and iron are observed in patients.