Nutritional Deficiencies in Crohn’s Disease: Pathogenesis, Clinical Significance, and Therapeutic Management

Abstract

Crohn’s disease (CD) is a chronic, relapsing-remitting inflammatory disorder of the gastrointestinal tract in which impaired nutritional status and nutritional deficiencies are common. This issue is of major clinical relevance, as deficiencies in both macro- and micronutrients not only reflect disease activity but may also influence disease course, treatment efficacy, and patients’ quality of life. The pathogenesis of nutritional deficiencies in Crohn’s disease is multifactorial and includes malabsorption, reduced dietary intake, increased metabolic demand, nutrient loss, and the effects of pharmacotherapy. The most frequently observed deficiencies involve protein and energy, iron, vitamin B12, vitamin D, folate, and selected minerals such as zinc and magnesium. Their clinical consequences include anemia, impaired bone mineralization, immune dysfunction, delayed tissue repair, and overall deterioration in health status. The problem is particularly important in the pediatric population, in whom deficiencies may result in impaired growth and development. The aim of this review was to present the mechanisms leading to nutritional deficiencies in Crohn’s disease, discuss their clinical significance, and summarize current diagnostic and therapeutic strategies.
The available evidence indicates that systematic nutritional assessment and appropriately selected nutritional interventions should constitute an integral part of comprehensive patient care.