My clinical nutrition experience in IBD at the Karolinska Institute exceeded all my expectations. I observed the excellent work of highly qualified dietitians and their integration within the multidisciplinary team, which included surgeons, gastroenterologists, nurses, pharmacists and nursing assistants. I was especially impressed by the patient-centred approach, characterised by attentive listening and clear explanation of all surgical, nutritional and pharmacological aspects throughout the hospitalisation period and outpatient follow-up.
The patients, who ranged in age from young adults to elderly, had highly complex disease that was typically severe, refractory to IBD treatments or associated with serious complications. Some had intestinal failure, resistance to multiple biologics or associated comorbidities, e.g. musculoskeletal and cardiovascular.
Parenteral and enteral nutrition was carefully calculated and aligned with the surgical or palliative intentions. Care was taken to respect patients’ cultural backgrounds (Syrian, Chilean, Peruvian, Lebanese, Swedish, etc.) and dietary preferences. The selected nutrition was always supported by scientific evidence.
The teamwork was harmonious and efficient—a true symphony of IBD care!
I also had the opportunity to follow the implementation of the Nutritional Care Process (NCP), which standardises the terminology in nutritional procedures in electronic reports. This system facilitates monitoring, improves clinical management and optimises the use of resources.
In the context of the research, I learned about various projects, especially in the field of nephrology, where I gained insights into the management of patients with renal risk associated with IBD, ostomies and short bowel syndrome.
At the end of my time at the Karolinska Institute, I gave a presentation to the team of nutritionists on how I offer online nutritional counselling to Portuguese-speaking IBD patients around the world, sharing my electronic resources for hospital and outpatient care, including strategies used during the acute and remission phases.
This immersive and enriching experience strengthened my clinical reasoning and broadened my perspective on patient-centered nutritional care in IBD.
