Gastroenterology Learning Network IBD Drive Time: Perioperative Optimization in IBD
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Apr 6, 2025 
Karen Zagian, a colorectal surgeon from Cedars-Sinai, and Kelly Isaacson, a dietician specializing in perioperative care, share their expertise on optimizing surgical outcomes for patients with inflammatory bowel disease. They discuss the impact of nutrition, the significance of immunonutrition, and strategies to manage anemia and obesity pre-surgery. The conversation emphasizes a holistic approach, integrating exercise and mental health support, as well as the importance of patient engagement for enhanced recovery. Their insights blend serious health topics with light-hearted personal anecdotes.
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Pre-Operative Risk Assessment
- Assess patients for recent weight loss, a key indicator of malnutrition.
- Check albumin and prealbumin levels if available, and inquire about steroid use, especially prednisone.
Modifiable Risk Factors
- Address smoking, even cessation for a week can improve outcomes.
- Treat iron deficiency anemia with iron infusions before surgery.
Malnutrition Screening
- Use a validated screening tool like the Malnutrition Screening Tool.
- Ask about recent unintentional weight loss and decreased appetite.