D-ECCO
13October2022

Nutrition assessment of IBD patients

Emma Halmos, D-ECCO Member

Emma Halmos 
© Emma Halmos

It has long been acknowledged that Inflammatory Bowel Disease (IBD) carries a risk of malnutrition, leading to fatigue, infection, poor wound healing and poor health-related quality of life [1]. Historically, most attention has been devoted to undernutrition; however, there is now evidence that overnutrition in the form of visceral fat is associated with raised tumour necrosis factor (TNF) and poorer responses to anti-TNF agents [2], indicating that central adiposity can be just as detrimental to disease outcomes as undernutrition. Furthermore, under- and overnutrition are not mutually exclusive and nutrient deficiencies and excesses often co-exist. In the last few years, there has been a shift away from the historical approach of using rudimentary markers of malnutrition, such as weight or body mass index (BMI), which can often be misleading as assessment tools in that they may falsely detect abnormalities or miss them completely, towards more detailed body composition measures of muscle and fat mass, which reflect nutritional abnormalities more sensitively. Indeed, GLIM (Global Leadership Initiative on Malnutrition) recognises the importance of body composition in the diagnosis of malnutrition [3]. The key question now is how should we best assess our IBD patients for nutritional status in order to identify risk of poor clinical outcomes?

Posted in ECCO News, Committee News, Volume 17, Issue 3, ECCO'22, D-ECCO

15June2022

Why do you need a dietitian (from the physician’s point of view)?

Eytan Wine, D-ECCO Member

Eytan Wine
© ECCO

Many IBD specialists take pride in their multidisciplinary team (MDT), which is of huge benefit and should be considered a necessity for this complex group of conditions. When I joined the Dietitians of ECCO (D-ECCO) Committee 3 years ago, I came with a clear appreciation of the specific role of dietitians in IBD MDTs, but I continue to learn and be amazed by how much more can and should be achieved through the contribution of IBD-focused dietitians. As a paediatric IBD specialist, I have had the privilege and pleasure of working with dietitians in our team for many years, mostly in the context of nutritional assessment and follow-up, as well as nutritional therapy. As nutritional therapy has been established as a first-line therapy for paediatric Crohn’s Disease for many years [1], it is likely that we paediatricians may have a head start in involving dietitians. While many adult centres have built excellent units [2], the specific roles of dietitians are not always appreciated [3].

Posted in ECCO News, Committee News, Volume 17, Issue 2, D-ECCO

28April2022

Report on the 7th D-ECCO Workshop at ECCO'22

Lihi Godny, D-ECCO Chair

Lihi Godny 
© ECCO

As a part of the 17th ECCO Congress, the 7th D-ECCO (Dietitians of ECCO) Workshop was conducted virtually and included three sessions: (1) Science, moving from a causality in IBD; (2) Practicalities and pitfalls of dietary therapy in IBD; (3) MDT: More than just the MD? Case presentations and panel discussion.

Posted in ECCO News, Committee News, Congress News, ECCO'22, Volume 17, Issue 1, D-ECCO

16December2021

Is the Low-Residue Diet Still Relevant?

Catherine Wall, D-ECCO Member

Catherine Wall 
© ECCO

The low-residue diet has been a short-term dietary strategy to help reduce the symptoms of active Crohn’s Disease and Ulcerative Colitis for at least the last half century. A longer term low-residue diet is also considered appropriate for a subset of patients with intestinal strictures [1], although the evidence to support this recommendation is limited and the type (fibrotic, inflammatory or both), severity (length of stricture and diameter of the bowel lumen), number of strictures and functional properties of certain foods likely impact tolerance of foods [1].

Posted in ECCO News, Committee News, Volume 16, Issue 4, D-ECCO

17September2021

Report on the 6th D-ECCO Workshop at ECCO'21

Lihi Godny, D-ECCO Member

Lihi Godny 
© ECCO

As a part of the 16th Congress of ECCO, the 6th D-ECCO (Dietitians of ECCO) Workshop was conducted virtually, with 84 participants. The workshop was divided into three sessions: (1) Science, diet and IBD; (2) Practical clinical nutrition in IBD; and (3) Panel discussion and interactive session.

Posted in ECCO News, Committee News, Congress News, ECCO'21, Volume 16, Issue 3, D-ECCO

29April2021

Dietary management of IBD: The patient’s perspective and bridging the clinician-patient divide

Dearbhaile O'Hanlon, D-ECCO Member

Dearbhaile O'Hanlon
© ECCO

“One cannot think well, love well, sleep well, if one has not dined well.” ― Virginia Woolf

Unfortunately for many of our patients, dining well is often not an option since their disease symptoms give rise to wariness about the foods they eat. Patients are forced to consider how they may feel after a meal and to take into account their requirement for toilet facilities and ability to cope with pain. They often forego social eating to manage these aspects. This can negatively impact their social interactions, daily activities and food-related quality of life [1]. Coupled with this, patients with IBD have higher rates of depression and anxiety [2] and a higher incidence of behavioural, psychological and eating disorders [3]. Self-directed food exclusions can trigger these disorders and lead to higher nutritional risk. We need to be mindful of this when addressing diet and nutrition with our patients. It is important that we consider the implications of asking patients to modify their diets for disease or symptom management while taking into account their desire to use diet as a tool to manage their disease.

Posted in ECCO News, Committee News, Volume 16, Issue 2, D-ECCO

25March2021

D-ECCO Activities in 2021

Marjo Campmans-Kuijpers, D-ECCO Chair

Marjo Campmans-Kuijpers
© ECCO

Due to COVID-19, the 16th ECCO Congress originally planned for February 2021 in Berlin was postponed to July 7–10 in the Bella Center in Copenhagen. However, in view of the current COVID-19 situation, the ECCO Governing Board had to switch to ECCO’ 21 Virtual Congress. It’s a pity we cannot meet each other live, but holding the Congress online may increase the opportunity for more people to attend both the Congress itself and our 6th D-ECCO Workshop.

Posted in ECCO News, Committee News, Volume 16, Issue 1, D-ECCO

15December2020

Nutritional Management of Iron Deficiency

Catherine Wall, D-ECCO Member

Catherine Wall
© ECCO

Iron deficiency and iron-deficiency anaemia (IDA) are characterised by fatigue and reduced capacity for normal activities of daily living and consequently poorer quality of life. Iron deficiency is estimated to affect 60%–80% of people with IBD at some point [1]. Recurrent iron deficiency is also common and is estimated to occur in 30% of patients [1]. Given the prevalence of iron deficiency, some patients and practitioners have learned to accept this impaired quality of life as an unavoidable consequence of IBD [2]. However, correction of iron deficiency in patients without anaemia can result in improved quality of life and less fatigue and should, therefore, be an important treatment goal.

Posted in ECCO News, Committee News, D-ECCO, Volume 15, Issue 4

30September2020

Telemedicine in IBD: MyIBDCoach

Marjo Campmans-Kuijpers, D-ECCO Chair

Marjo Campmans-Kuijpers 
© ECCO

During the recent COVID-19 outbreak, telemedicine was helpful in ensuring the continuation of regular care and reducing the need for outpatient visits. To optimise the treatment of Inflammatory Bowel Disease (IBD), recent guidelines recommend strict long-term monitoring of the mucosal inflammation and timely optimisation of treatment during a disease flare [1]. In traditional practice, such monitoring requires many visits to outpatient clinics by patients, which they can experience as stressful. This regular monitoring increases the workload and administration during outpatient visits and can lead to longer waiting lists. In order to address some of these issues and continue to provide patients with good and qualitatively safe care, the multidisciplinary team (MDT) together with the Dutch patient association (CCUVN) developed the telemonitoring tool MyIBDCoach. In the Netherlands, there are currently about 90,000 patients with IBD [2] and 10% of these patients are using MyIBDCoach.

Posted in ECCO News, Committee News, D-ECCO, Volume 15, Issue 3

30June2020

The role of the dietitian in the Inflammatory Bowel Disease Multidisciplinary Team

Dearbhaile O'Hanlon, D-ECCO Member

Dearbhaile O'Hanlon 
© ECCO

D-ECCO is committed to promoting the essential role of dietitians within the Inflammatory Bowel Disease Multidisciplinary Team (IBD MDT). Specialist IBD dietitians in IBD units are integral to the MDT, but not all IBD units have a specialist dietitian. Dietetic services and clinical roles are likely to differ slightly from country to country, but the core roles will remain the same. The European Federation of the Associations of Dietitians (EFAD) has adopted the International Congress of Dietetic Associations (ICDA) definition of the role of the dietitian: “A person with a qualification in Nutrition & Dietetics recognized by national authority(s). The dietitian applies the science of nutrition to the feeding and education of groups of people and individuals in health and disease.”

Posted in ECCO News, Committee News, D-ECCO, Volume 15, Issue 2