Investigators concluded that pre-surgery nutrition support may cut hospital stays for  patients with IBD, but bigger studies are needed.

The following is a summary of “Effects of Nutrition Status and Perioperative Nutrition Supplement Completion on Postoperative Outcomes in Patients with Inflammatory Bowel Disease Undergoing Surgery,” published in the January 2024 issue of Gastroenterology by Crohn’s & Colitis Congress 2024.

Inflammatory bowel disease (IBD) patients often face malnutrition, linked to worse health, length of stay (LOS) with 30 days of readmission, and increased readmissions, prompting an investigation of rehabilitation programs, including nutrition counseling, to improve outcomes after surgery.

Researchers started a retrospective study on how malnutrition and perioperative nutrition support impact surgical outcomes in IBD patients within a multimodal rehabilitation program.

They involved patients aged 18-80 in a 10-week prehabilitation program before undergoing surgery for IBD. Four weeks pre-surgery, patients consulted a diverse team: a nurse practitioner, physical therapist, and registered dietitian. Three preoperative carbohydrate loading oral nutrition supplements (ONS) 48 hours were provided before surgery, and 20 perioperative immunonutrition ONS were provided. Malnutrition, assessed per Global Leadership in Malnutrition criteria, was categorized as moderate or severe. Fisher’s test identified links between malnutrition, ONS use, and postoperative complications. Postoperative complications were defined using the comprehensive complication index (CCI), with CCI scores >20 categorized as severe and examined 30-day readmission rates. Used logistic and linear regression to assess LOS, opioid use (morphine milligram equivalents, MME), nutrition status, and ONS completion

The results showed 25 patients (48% female, mean age 44, 18 (72%) with Crohn’s disease) completed the prehabilitation program (05/2022 to 10/2023). Malnutrition criteria were met by 10 patients (40%), with an even split between moderate and severe cases. Malnutrition did not correlate with CCI severity (P=0.07), LOS (P=0.07), opioid use (P=0.07), or 30-day readmission rates (0.06). Higher ONS utilization for carbohydrate loading and immunonutrition linked to LOS<5 days likelihood (P=0.05 and P=0.03, respectively).

Investigators concluded that pre-surgery nutrition support may cut hospital stays for IBD patients, but bigger studies needed.