Patients who manage GI disease with special diets ‘need closer follow-up’



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WASHINGTON — In a Healio video exclusive, Shirley Paski, MD, discusses highlights from her presentation at Digestive Disease Week, which focused on the importance of screening patients on special diets for nutritional risks and malnutrition.

“One thing we often don’t think about when we’re starting patients on a diet for treatment of their GI disease is other factors that can contribute to malnutrition as a result of following a special diet,” Paski, a staff gastroenterologist at Cleveland Clinic, told Healio.

According to Paski, malnutrition etiology is often multifactorial and may include difficulty with intake, inability to digest and absorb nutrients, or other pathology.

“When we start to place patients on a special diet, particularly elimination, you can end up in a position where you are placing a patient at increased nutritional risk due to restricted foods, as well as all the other factors that can contribute to malnutrition,” she said.

Screening for malnutrition is critical to identify patients who “require additional counseling from a registered dietitian or special attention from a gastroenterologist,” she said, noting this may include:

  • The Malnutrition Screening Tool, which assesses weight, weight loss and appetite;
  • The Malnutrition Universal Screening Tool, which also includes BMI and short-term intake inability; and
  • Nutritional Risk Screening 2002, which also incorporates disease severity and can be helpful for inpatients or those undergoing surgery.

“We appreciate that altered diets increase the risk for malnutrition and nutritional deficiencies, and that in the setting of active GI disease and altered anatomy, those patients need closer follow-up and may benefit from the attention from a dietician,” Paski said.


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