Since specific treatment has not yet been decided on for
Crohn's disease, the immediate target is the
induction of remission and its maintenance. We examined the effects of an elemental diet (ED) in
Crohn's disease with special reference to the maintenance of remission. Eighty-four patients received total
enteral nutrition with the ED (35 to 40 kcal/kg ideal body weight/day) and/or conventional
drug treatment for
induction of remission. Sixty-one patients in remission were then followed-up with prolonged ED
therapy (home elemental enteral hyperalimentation, HEEH) and/or drugs. During the follow-up periods the course of patients receiving HEEH was better than those of patients without HEEH, namely the cumulative continuous remission rates after one, 2 and 4 years were, 94%, 63% and 63% in the group receiving HEEH, 75%, 66% and 66% in the group receiving HEEH and drugs, 63%, 42% and 0% in the group receiving drugs, and 50%, 33% and 0% in the group receiving no maintenance
therapy, respectively. In particular, when more than 30 kcal/kg ideal body weight/day of the ED was given, the maintenance of remission was successful in 95% of the patients. These results indicated that ED
therapy was effective not only for the
induction of remission but also for the maintenance of remission in
Crohn's disease.