Share this article on:

Knowledge, Attitudes, and Beliefs Regarding the Role of Nutrition in IBD Among Patients and Providers

Tinsley, Andrew MD, MS; Ehrlich, Orna G. MPH; Hwang, Caroline MD; Issokson, Kelly MS, RD; Zapala, Sophia; Weaver, Alandra MPH; Siegel, Corey A. MD, MS; Melmed, Gil Y. MD, MS

doi: 10.1097/MIB.0000000000000901
Original Clinical Articles

Background: Malnutrition is common in inflammatory bowel disease (IBD). Identifying patients who are malnourished or at risk for malnutrition may lead to early intervention and improve patient outcomes. To date, little is known about the role of nutritional assessment and management in IBD care. We aimed to evaluate knowledge, attitudes, and beliefs regarding nutrition in IBD among patients and providers.

Methods: Surveys were mailed electronically to patients and providers identified through their membership in the Crohn's & Colitis Foundation of America. In addition, patient and provider focus groups were conducted to explore nutrition-related themes. These surveys and focus groups were designed to evaluate knowledge and perceived importance of nutrition, patient–provider interactions regarding nutrition and use of nutritional resources.

Results: There were 223 provider respondents (65.5% gastroenterologists, 15.2% nurses, and 6.7% dietitians). Forty-one percent of the gastroenterologists rated their knowledge of nutrition in IBD as “very good” compared with 87% of dietitians and 16% of nurses (P < 0.001). Thirty-three percent of the gastroenterologists reported not routinely screening their IBD patients for malnutrition. The patient survey had 567 respondents with 27% rating their knowledge of nutrition in IBD as “very good.” In the focus groups, a lack of adequate IBD nutritional resources was evident along with a desire for improved access to nutrition specialists.

Conclusions: Significant gaps in knowledge relating to nutrition in IBD seem to exist. Targeted educational initiatives and improved access to nutritional experts are warranted. In addition, a standardized process for the assessment of malnutrition among patients with IBD should be developed.

Supplemental Digital Content is Available in the Text.Article first published online 6 September 2016.

*Division of Gastroenterology and Hepatology, Penn State College of Medicine, Hershey, Pennsylvania;

Crohn's & Colitis Foundation of America, New York, New York;

Division of Gastroenterology, Keck School of Medicine of University of Southern California, Los Angeles, California;

§Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California;

Survey Research Institute, Cornell University, Ithaca, New York; and

Division of Gastroenterology, Dartmouth Hitchcock Medical Center, Dartmouth, Hanover, New Hampshire.

Address correspondence to: Andrew Tinsley, MD, MS, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033 (e-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

This work was sponsored with an educational grant from Nestle Health Sciences (NHS). NHS did not participate in the design or conduct of the surveys or focus groups, nor the decision to publish.

Received November 04, 2015

Accepted June 27, 2016

© Crohn's & Colitis Foundation of America, Inc.