The Role of Enteral Nutrition in Patients with Inflammatory Bowel Disease: Current Aspects

Table 1

Causes of malnutrition in patients with IBD [7–9, 11–14].

Decrease in oral intake	(i) Restrictive diets; (ii) Therapeutic fasting; (iii) By the disease itself due to diarrhea, abdominal pain, nausea, and vomiting [9]; (iv) Alteration in taste due to drugs, vitamin and mineral deficiencies, and proinflammatory mediators [7]; (v) Anorexigenous effect of proinflammatory cytokines [7]
Gastrointestinal losses	(i) Diarrhea; (ii) Rectorrhagia/hematochezia; (iii) Loss of mucus and electrolytes; (iv) Protein-losing enteropathy
Metabolic disorders	(i) Increase in resting energy expenditure due to inflammation, fever, and sepsis; (ii) Enhanced fat oxidation
Increase in nutritional requirements	(i) Inflammatory states [7]; (ii) Increased basal oxidative metabolism; (iii) Infectious complications; (iv) Postsurgery
Drug interaction	(i) Corticosteroids and calcium reabsorption; (ii) Corticosteroids and protein catabolism; (iii) Salazopyrin and folates [11]; (iv) Methotrexate and folates [11]; (v) Cholestyramine and liposoluble vitamins [11]; (vi) Antimicrobials and vitamin K [12, 13]; (vii) Antisecretors and iron [14]
Poor absorption of nutrients	(i) Reduction of the absorptive surface due to intestinal resection and enteric fistulas [8]; (ii) Blind loops and bacterial overgrowth; (iii) Poor absorption of bile salts in ileitis or resection [8]; (iv) Mucosal inflammation