What additional workup would you do for this patient to assess nutritional status?
Choose the single best answer
Micronutrient testing
Incorrect, choose again!
Sarcopenia assessment with CT scan to assess psoas muscle diameter
Incorrect! choose again! To date, there is no standard of care evaluation for sarcopenia and this is not currently part of any nutrition guideline. Therefore, it would not be helpful to obtain a CT scan to evaluate muscle health
Further dietary assessment
Incorrect, choose again! While dietary assessment is an important step in testing, it is not the only next step required for work up.
Micronutrient testing and dietary assessment
Good choice! This patient is at risk for malnutrition. It is very important to assess micronutrient status, including vitamins and minerals. The latest guideline on nutrition and IBD recommend routine micronutrient testing at time of diagnosis and regularly thereafter. This is especially true in a patient who may have skin or other exam findings that are concerning for a nutrient deficiency.
Dietary assessment is also important for for all IBD patients. Many patients will report a “normal diet”, however, what is normal to the patient may in fact be abnormal. Many patients change their diet to minimize symptoms or because of something a provider or family/friend has told them- however, if we do not ask about a typical day of eating and go through each meal, we may miss on key dietary deficiencies as in this case.
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