When you have Crohn’s disease, malnutrition is a fairly common diagnosis and can be dangerous if it gets bad enough. Crohn’s disease often prevents the body from properly digesting food and absorbing nutrients necessary to thrive. Being malnourished is a direct result of malnutrition.
What does it mean to have malnutrition?
Malnutrition occurs when there aren’t enough nutrients in the body either due to a poor diet or a medical condition that complicates nutrient absorption. Crohn’s disease causes inflammation throughout the digestive tract, but most commonly the small intestine, which is where critical nutrient absorption takes place. Long-term inflammation can damage the lining of the intestines, interfering with the organs’ ability to absorb nutrients.
Surgery on the intestines is another risk factor for malnutrition, especially small intestine resections. Intestinal surgery decreases the amount of space in which your body can absorb nutrients. If the intestine becomes short enough, a rare condition known as short bowel syndrome can occur.
How is malnutrition diagnosed?
Your doctor may look into several types of nutritional deficiencies. Symptoms associated with malnutrition include:
- General fatigue
- Unintentional weight loss
- Problems with concentration
- Muscle weakness
- Loss of muscle mass
- Longer recovery time from injury or illness
Bloodwork is used in diagnosis to check the body’s general nutrition levels, as well as vitamin and mineral deficiencies. One blood test that doctors will look at is the albumin level. Albumin levels give doctors a better idea of how your body is doing, as low levels can indicate inflammation, lack of protein, and malnutrition associated with Crohn’s disease.
There are numerous vitamins and minerals everyone with Crohn’s disease needs. A variety of nutritional deficiencies also can occur, including vitamin D deficiency and vitamin B-12 deficiency.
How to treat malnutrition
Treatment depends on the underlying cause and extent of the malnutrition. Left untreated, malnutrition can become dangerous, so it is imperative the deficiencies be corrected.
If the inability to absorb vitamins and minerals stems from dietary issues, supplements are usually suggested. After the bloodwork, your doctor will be able to tell which deficiencies are present and which need to be supplemented. It’s always best to go through your doctor for supplemental recommendations.
If the malnutrition is severe, sometimes IV therapy of a medication called total parenteral nutrition (TPN) is required. TPN is not ideal for long-term use because it has some complications, but short-term therapy can help someone whose GI tract is not functioning, or if they need to be on a bowel rest for a period of time. Many times, people who have had surgeries on the small intestine are more likely to need TPN.
Other malabsorption issues can be linked with Crohn’s disease
Medications aren’t much different than food when it comes to malabsorption associated with Crohn’s disease. Depending on how fast medication moves through the stomach and intestines, some medications might not be absorbed correctly.
Most pills are designed to release at certain parts of the digestive tract: Some capsules dissolve and release in the stomach, while others are absorbed in the small intestines.
A few months ago, I was in the middle of a Crohn’s flare and noticed I was passing whole pills and was even able to identify which medications they were. I called my gastroenterologist and told him what was going on. He said that because I was having so much diarrhea, my medications were going through me too fast to absorb, just like food. Until the flare calmed down, he wanted me to look at a low-residue diet to help slow everything down.
Recently, I’d been experiencing more seizures than normal, so I made an appointment to see my neurologist. I knew that one of the pills I’d been passing was my seizure medication. They ran a blood test to see how well my body was absorbing the medication, and the results showed I was barely absorbing it. My doctor’s next question was how my Crohn’s had been faring. Just in case, my doctor adjusted the medication dose and rechecked a couple of weeks later. Thankfully, it was within a good range.
I knew malnutrition was a risk of Crohn’s, I just never knew that included not absorbing medications as well!
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