Oral nutritional supplementation is effective in the maintenance of remission in Crohn's disease.

Abstract

BACKGROUND:

Enteral feeding with either elemental or polymeric diets is an established primary therapy for active Crohn's disease. However, the role of supplementing normal food with elemental diet in the long-term management of Crohn's disease has hitherto not been explored.

PATIENTS AND METHODS:

A series of 39 consecutive patients with Crohn's disease in clinical remission were studied. Of these, 21 patients (Group 1) received oral nutritional supplementation, taken in addition to their normal diet. Their outcome (relapse rate, Crohn's disease activity index, inflammatory markers) was compared with that of 18 patients (Group 2), who were maintained on a normal unrestricted diet over an observation period of 12 months.

RESULTS:

A total of 17 patients (81%) tolerated the nutritional supplementation. On an intention-to-treat basis, 10 patients (48%) remained in remission for 12 months, compared to 4/18 (22%) patients in Group 2, p<0.0003. Their Crohn's disease activity index and CRP remained stable while their weight and body mass index improved during the period of nutrition therapy Seven patients in Group 1 and 14 in Group 2 relapsed at a mean of 7.4+/-0.9 and 6.2+/-0.4 months, respectively. The response to nutrition supplement was independent of age, sex, disease duration or location. Four patients (19%) were intolerant to enteral feeding.

CONCLUSIONS:

Nutritional supplementation is safe, well tolerated and effective in the long-term management of patients with quiescent Crohn's disease.

• Authors: S Verma, B Kirkwood, S Brown, M H Giaffer
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 32 Issue 9 Pg. 769-74 (Dec 2000) ISSN: 1590-8658 [Print] Netherlands
• PMID: 11215556 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Administration, Oral
• Adult
• Crohn Disease (diagnosis, therapy)
• Enteral Nutrition (methods)
• Female
• Follow-Up Studies
• Humans
• Long-Term Care
• Male
• Middle Aged
• Nutritional Requirements
• Nutritional Support
• Probability
• Reference Values
• Sensitivity and Specificity
• Severity of Illness Index
• Statistics, Nonparametric
• Treatment Outcome
• United Kingdom