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Malnutrition in Crohn's disease — ESEGH MCQ

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HardNutritionMalnutrition in Crohn's diseaseESEGH

A 35-year-old man with stricturing Crohn's disease is planned for elective ileocaecal resection. He has BMI 16.8 kg/m2, albumin 24 g/L and has lost 14 kg over 4 months. He can tolerate liquids but little solid food. There is no complete obstruction. What is the most appropriate management?

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Correct answer: CPreoperative nutritional optimisation using enteral nutrition where feasible

Severe malnutrition before Crohn's surgery increases complications, and enteral nutritional optimisation is preferred when the gut is usable. Parenteral nutrition is reserved for inadequate or impossible enteral intake. Steroids may worsen surgical risk and do not directly correct malnutrition. The pearl is that nutritional therapy is part of surgical risk reduction in IBD.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/digestive-tract-conditions