I just wrapped up grading for my NYU class, Diseased Gut. Glamorous, I know.
Every year on the exam, I ask my students this question:
“When seeing a new patient with Crohn’s disease, what’s the first question you should ask?”
While there are many valid answers, the one I’m looking for is:
“What kind of Crohn’s do they have?”
Crohn’s disease can affect any part of the GI tract—from the mouth to the very bottom—and often presents with complications like fistulas or strictures.
Knowing the type and location of the disease is key to providing effective nutrition care.
Here’s why:
- To identify, prevent and correct nutrient deficiencies: Knowing the disease’s location helps pinpoint which nutrients may be maldigested or malabsorbed (e.g., vitamin B12 in those with Crohn’s ileitis).
- To reduce the risk of bowel obstructions: For patients with stricturing Crohn’s, dietary and behavioral changes, such as eating smaller meals and avoiding roughage, can reduce the risk of obstructing.
- To choose a therapeutic diet: Disease type and location can help determine if diets like the Crohn’s Disease Exclusion Diet (CDED) or exclusive enteral nutrition (EEN) are appropriate.
Surprisingly, many people don’t know where their disease is located.
As IBD providers, it’s not just about gathering this information (ideally from the medical record or GI team)—it’s also about making sure patients understand it.
Educating patients about their disease empowers them to take a more active role in their health—and allows us to provide personalized, evidence-based care.
