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.com
Volume 8
Journal of Obesity & Weight Loss Therapy
Obesity Meeting 2018
August 24-25, 2018
August 24-25, 2018 Singapore
20
th
Global Obesity Meeting
Obesity and severe Crohn’s disease
Wita Tando, Haerani Rasyid, Mardiana Madjid
Hasanuddin University, Indonesia
Background:
About 15–40% of patients with IBD are obese, which might contribute to the development of IBD. Obesity
is recognized as a state of chronic low-grade inflammation. There are two approaches that are suspected to link obesity to
IBD that is the role of visceral adiposity “creeping fat” and dysbiosis. Visceral adiposity has been independently associated
with increased risk of IBD-related complications and disease severity. Obesity might modify response to immunomodulator
therapy in IBD.
Case report:
A 31 year-old man, was referred to us in September 2017 with Severe Crohn’s Disease with hematochezia. In 2013,
he was diagnosed with Crohn’s Disease and his BMI was 28.6 kg/m
2
(weight 78 kg). Before illness, patient used to consume
traditional foods containing red meat, fried food and soft drinks. He rarely ate vegetables and fruits, and rarely exercise. In early
2017 patient were diagnosed with Chronic Kidney Disease on regular hemodialysis. His metabolic status was anemia, immune
depletion, hypoalbuminemia, and electrolyte imbalance. On primary survey, his weight was 45 kg. Upper Gastrointestinal
Endoscopy showed gastritis hemorrhagic. Lower Gastrointestinal Endoscopy revealed signs of severe Crohn’s disease, stricture,
entero-colic fistula, and anal fissure. Nutritional therapy was given in order to meet energy requirement, considering the
nutritional route and macronutrient composition also type of formula (polymeric vs elemental). Supplementation should be
given to prevent micronutrient deficiencies, decrease inflammation and improve the immune system (vitamin D and zinc).
After 34 days of nutritional therapy, the frequency of hematochezia was decreased, accompanied by increase of plasma albumin
and lymphocyte count.
Conclusion:
Epidemiological studies, in particular prospective cohort study, implicating obesity in the development of IBD are
limited, although there is an evidence from a pathophysiological perspective. This case report may encourage more prospective
research about effects of obesity on incidence, course of disease, and treatment response to IBD and also the effect of obesity
treatment to IBD outcomes. The aim of nutritional therapy in Crohn’s disease is to reduce inflammation, improve the immune
system and intestinal homeostasis, also induce and maintain of remission.
Biography
Wita Tando is Clinical Nutrition Specialist Program participant in Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. She earned her Medical Doctor
in 2007. She worked at Community Health Centre for 8 years, focus on prevention and treatment of non-communicable disease. In 2015, she enrolled in Clinical
Nutrition Specialist Program at Hasanuddin University.
witatando@gmail.comWita Tando et al., J Obes Weight Loss Ther 2018, Volume 8
DOI: 10.4172/2165-7904-C6-073