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Title: Nutritional and immunological studies in inflammatory bowel disease
Author: Ghosh, Subrata
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1996
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In this thesis I have investigated the direct contribution of inflammatory bowel disease in specific nutritional problems such as osteopenia. I have also developed clinically applicable objective measures of different aspects of gut inflammation so that the interface between gut inflammation and nutritional abnormalities may be explored. Bone mineral density and biochemical parameters of bone metabolism were measured in patients with newly diagnosed inflammatory bowel disease prior to medical therapy or surgery. I established that, at diagnosis, low bone mineralization is a feature of Crohn's disease but not ulcerative colitis. Disease activity, anatomy of involvement, body mass index, smoking habits, sex, physical activity or biochemical parameters did not account for this difference. Follow-up over a period of one year showed no further bone loss in spite of steroid therapy. Previous studies which had not shown any difference between Crohn's disease and ulcerative colitis had recruited unselected patients with predominantly long-standing disease. When I studied patients with long-standing inactive inflammatory bowel disease, spine and forearm bone mineral density were equally low in both Crohn's disease and ulcerative colitis. Adolescents with long-standing inflammatory bowel disease were identified as a specially vulnerable group for osteopenia. Since bone is only one of the compartments of the body, I next investigated methods to assess body composition in clinical practice. Simple portable, user-friendly bioelectrical impedance analysis machines have recently become available. I evaluated one such machine by comparing it with a standard bioelectrical impedance machine available in medical physics department and with dual energy X-ray absorptiometry, a standard method of measuring lean body mass. The results showed that this machine measured lean body mass as accurately as the more expensive, non-portable machines.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available