Table 1.
Causes of malnutrition in IBD (modified from García-Manzanares et al[63])
| Decrease in oral intake | Restrictive diets, therapeutic fasting |
| By the disease itself: diarrhea, abdominal pain, nausea and vomiting, etc | |
| Alteration in taste: due to drugs, vitamin and mineral deficiencies, pro-inflammatory mediators | |
| Anorexigenous effect of pro-inflammatory cytokines | |
| Gastrointestinal losses | Diarrhea |
| Rectorrhagia/hematochezia | |
| Loss of mucus and electrolytes | |
| Protein-losing enteropathy | |
| Metabolic disorders | Increase in resting energy expenditure |
| Enhanced fat oxidation | |
| Increase in nutritional requirements | Inflammatory states |
| Increased basal oxidative metabolism | |
| Infectious complications | |
| Post-surgery | |
| Drug interaction | Corticoids and calcium reabsorption |
| Corticoids and protein catabolism | |
| Salazopirine and folates | |
| Methotrexate and folates | |
| Cholestyramine and liposoluble vitamins | |
| Antimicrobials and vitamin K | |
| Anti-secretors and iron | |
| Poor absorption of nutrients | Reduction of the absorptive surface: intestinal resection, enteric fistulas, hypertrophy of the villi |
| Blind loops, bacterial overgrowth | |
| Poor absorption of bile salts in ileitis or resection |