Nutritional status and dietary habits of patients with inflammatory bowel disease in comparison with patients with irritable bowel sindrom

Abstract

Upalne bolesti crijeva (IBD) su heterogena skupina bolesti (Crohnova bolest, ulcerozni kolitis), a očituju se kroničnom aktivacijom imunosnog odgovora i upalom na različitim mjestima uzduž probavnog sustava. Sindrom iritabilnog crijeva (IBS) je kronični funkcionalni poremećaj probavnog sustava kojeg karakterizira bol u trbušnoj šupljini i poremećaj funkcije crijeva, ali bez strukturnih ili biokemijskih abnormalnosti. Cilj ovoga rada je bio procijeniti prehrambene navike, nutritivni status i kvalitetu života obaju navedenih skupina, što je provedeno antropometrijskim, dijetetičkim i laboratorijskim ispitivanjima. U istraživanje su uključeni ambulantni pacijenti Kliničkog bolničkog centra Zagreb – Rebro, pri čemu je 28 pacijenata dobi od 19 do 61 godine činilo eksperimentalnu skupinu s dijagnozom IBD-a, dok su preostala 34 pacijenta dobi od 21 do 55 godina s dijagnozom IBS-a predstavljala kontrolnu skupinu. Antropometrija je uključivala mjerenje tjelesne visine i mase te izračun indeksa tjelesne mase, a dijetetičke metode NRS2002 i IBDQ obrasce te dnevnik prehrane. Laboratorijska mjerenja su uključivala praćenje statusa vitamina (D, B12, folna kiselina), željeza, feritina, kalprotektina, CRP-a te fibrinogena. Iako obje skupine u prosjeku imaju normalnu tjelesnu masu i nizak nutritivni rizik, pokazalo se kako IBD skupina ima prosječno veće vrijednosti ITM – a, a prema IBDQ obrascu, i veću kvalitetu života od IBS skupine. U IBD skupini zabilježen je nedostatan unos vitamina A, D, E, magnezija i cinka, dok IBS skupina unosi nedovoljno vitamina A, C, D, E, K, cinka, magnezija te željeza. Laboratorijskim se ispitivanjima utvrdilo kako IBD skupina ima značajno više vrijednosti kalprotektina, fibrinogena i folne kiseline, a značajno niže vrijednosti željeza, što ukazuje na upalni karakter bolesti i veću učestalost problema apsorpcije koji se susreću kod IBD-a.Inflammatory bowel disease (IBD) is a heteregenous group of disease (Crohn disease, ulcerative colitis) characterized by chronic activation of immune system and inflammation along gastrointestinal tract. Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder specific by abdominal pain and gut function disorder, without any structural or biochemical abnormalities. The aim of this study was to evaluate dietary habits, nutritional status and quality of life for both mentioned groups, what was performed with antropometric and dietetic methods and laboratory testing. The research included ambulant patients from University Hospital Centre Zagreb – Rebro. While 28 patients at age range from 19 to 61 with an IBD diagnose made an experimental group, the remaining 34 patient at age range from 21 to 55 with an IBS diagnose were representing control group. Antropometry included measuring of height, body mass, calculation of body mass index and dietetic methods consisting of dietary diary, NRS2002 and IBDQ forms. Laboratory measurements included vitamins (D, B12, folic acid), iron, ferritin, calprotectin, CRP and fibrinogen status. Both groups have normal body mass and have low risk of malnutrition, however, IBD group has higher BMI values and, according to IBDQ form, better quality of life. IBD group also reports vitamins A, D, E, magnesium and zinc deficiency, while IBS group being deficient in vitamins A, C, D, E, K, zinc, magnesium and iron. Laboratory testing found significantly higher levels of calprotectin, fibrinogen, folic acid and significantly lower levels of iron in IBD group. This indicates that character of disease is inflammatory and also explains frequent problems with apsorption in patients with IBD