Mistakes in ... 2021 - 11

ueg education
Mistakes in... 2020
Clinical decision made to assess
micronutrient biomarkers
Is systemic inflammatory response
(e.g. raised CRP) or low albumin
present?
No
Does the patient have a chronic
high nutrition risk condition?
No
* In case of abnormal biomarkers,
additional steps are required to
complement VTE assessment
Additional steps to confirm VTE deficiency or complement assessment
* Further assessment using functional tests or markers
* Full assessment using functional tests or markers
* Full clinical examination
* Referral to nutrition support team including dietician for assessment
* Repeat measures to confirm
Figure 3 | A decision tree for the evaluation of vitamin and trace element (VTE) status with laboratory
biomarkers. Reproduced from Gerasimidis K, et al. J Pediatr Gastroenterol Nutr 2020; 70: 873-881 © 2020 by
ESPGHAN and NASPGHAN, with permission from Wolters Kluwer.
guidelines recommend prescribed endurance
exercise for all patients with IBD, as well as
weight-bearing exercises for those with, or at risk
of, sarcopenia. 44
Bottom line: Exercise is safe and probably
beneficial for patients with IBD in several key
areas. Gastroenterologists should utilise and
promote the philosophy that " exercise is
medicine " to complement other nutritional
strategies in place for IBD patients.
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Yes
* Abnormal biomarkers very
likely to indicate VTE deficiency
Yes
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* Interpretation may be invalid
* Consider additional steps below
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