I was recently made aware of a useful website for IBD patients interested in nutritional therapy: Nutritional Therapy for IBD -Home Page
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- Can IBD Be Treated with Diet Alone?
- Good Food and Bad Food for Crohn’s Disease -No Agreement | gutsandgrowth
- Pushing the Boundaries on Dietary Therapy for Crohn’s Disease: CD-TREAT
- Position Paper: Nutrition in Pediatric IBD
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EB Mitchell et al. Journal of Pediatric Gastroenterology and Nutrition. 72(5):742-747, May 2021.Venous Thromboembolism in Pediatric Inflammatory Bowel Disease: A Case-Control Study
Methods: A nested case-control study comparing hospitalized children with IBD diagnosed with VTE to those without VTE over a decade at a large referral center
- Twenty-three cases were identified.
- Central venous catheter (CVC) presence (odds ratio [OR] 77.9; 95% confidence interval [CI]: 6.9–880.6; P < 0.001) and steroid use (OR 12.7; 95% CI: 1.3–126.4; P = 0.012) were independent risk factors
- Table 2 lists five severe cases which included interventions like balloon angioplasty, stent placement, surgical thrombectomy, and plasmapheresis/subtotal colectomy
- The authors note that 1.3% of adolescents/children hospitalized with IBD had VTE
The authors note that ‘inherited prothrombotic disorders are not increased in IBD; “the pathogenesis of VTE in patients with IBD has been associated with increased activation of the coagulation cascade, impaired fibrinolysis, increased platelet count, and dysfunction of the endothelium.”
My take: The absolute risk of VTE is low in the pediatric population; presence of CVC and use of steroids are risk factors and require consideration of, at minimum, nonpharmacologic interventions.
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