IBD – diet and nutrition

IBD – diet and nutrition


(upbeat music)
So I support children and
young people with IBD.
So if they are struggling to gain weight,
maybe because of the disease
or because they’re not
really feeling that great
and don’t really want to eat,
I would help support them
from that point of view
to see what we can do
to try to help them grow
to the potential that
they should be getting.
I also help them if they have to go onto
liquid nutrition therapy
and support them through.
We’ll see them in clinics to
make sure that they’re growing,
get their weights, give
them extra support at home
if they need it through telephone calls
to make sure that they’re doing okay
with the diet that they’re on as well.
(upbeat music)
Liquid nutrition therapy is
used to treat Crohn’s disease.
It’s where the patient takes the nutrients
that they need, so the
calories and the protein
and the vitamins and minerals
and this all comes in a liquid form.
The dietitian will work
out how much they need
to drink to make sure
that everything’s met
and that they still grow.
Patients tend to be on
it for six to eight weeks
and they can’t have anything
else to eat or drink
apart from tap water as well.
No one really knows why it works,
we just know it does work
in the majority of patients,
about 80% of patients respond to it.
It’s got no side effects.
So it’s nicer than going on
to something like steroids,
which is why we use it as a
first line treatment as well.
Everywhere does it, there might be some
discrepancies in different areas.
When we do it, after your
eight weeks you go straight
back on to your normal diet, straight away
and hopefully your symptoms
have improved by that point.
We do assess at about the
halfway point to see whether or
not there is any improvement
with your bloods, stool
samples and also looking at
your symptom scores as well.
If they’ve all improved then you continue
but if you haven’t quite
responded then we’ll
take you off and normally look at
different alternative treatment as well.
(upbeat music)
If someone’s going on to
liquid nutrition therapy
it’s usually because they’ve
just been diagnosed with Crohn’s disease.
They probably would’ve
gone for their endoscopy,
got their results back and
been told that they’ve got
Crohn’s disease and
that needs to be treated
and then they’ll be going on
to liquid nutrition therapy.
Unfortunately it doesn’t
work in ulcerative colitis.
They might also be going on
to it if they’ve responded
really well in the past to
liquid nutrition therapy
and they’ve just had a bit of a relapse.
Then they might be going back on to it
to try and get everything under control.
(upbeat music)
So if we’re seeing a
child with Crohn’s disease
because they’re being treated
with liquid nutrition therapy,
we tend to see them when
they’re on hospital ward.
They tend to be there for
about three days or so
while we get them built up on the volume.
What they get from us
is that we’ll explain
why they’re going on
liquid nutrition therapy,
how we’re going to do it, what
happens when they get home,
tips that they can do with the drinks
that they’re having to
have, whether it’s making
ice lollies with them,
some people try to make it
in to ice cream as well
and then talking about
how we can help them
with schools going on to
liquid nutrition therapy and
trying to give them support
to make sure that they can
definitely drink the volume
that they need to have.
If they’re coming in to clinic to see us
because they’re not maybe
gaining weight how they need
to gain weight or they’re
not really growing
how we want them to grow,
then what would happen
is they’ll come and see us,
we’d probably take a weight and height.
We would then also go through the diet,
what they tend to eat on the average day
to look to see if there’s
anything that we can do
from a food point of view first of all
to help get extra calories
in or if they’re struggling
from that and there isn’t
really anything else
we can do from a diet point of view
then there’s often
special drinks or puddings
that we can put them on to try
and help with the weight
gain and the height as well.
(upbeat music)
I think it’s always a concern of parents,
whether or not everyone’s
getting everything that they need
and it is really really hard to ensure
that patients get everything.
We tend to look at the diet as a whole.
So we’d be looking to see whether they are
getting a balanced diet,
it’s important to make sure
there is some protein sources going in,
there’s some carbohydrate
sources, that there’s some
vegetables and fruits to get your vitamins
and minerals in as well, that
there’s some dairy going in
to make sure you’re getting
calcium to help your bones
stay strong when you’re growing.
I think it’s making sure
that you get a little bit
of all of that going in
but it’s also important
to acknowledge that these are children
and they are going to want to go out
and have the occasional treat
and that is absolutely fine to do.
It’s just within moderation.
If you’re really really
struggling to get everything
in to the diet and you are concerned,
then you can ask to see a dietitian
and we can have a look and
help and see whether or not
something like a multivitamin might help
from that point of view as well.
(upbeat music)

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