This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ostro, M.J. Articles by Jeejeebhoy, K.N. Search for Related Content PubMed PubMed Citation Articles by Ostro, M.J. Articles by Jeejeebhoy, K.N. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Crohn's Disease Social Bookmarking                         What's this?

Total Parenteral Nutrition and Complete Bowel Rest in the Management of Crohn's Disease

Departments of Medicine, University of Toronto and Toronto General Hospital, Toronto, Canada

G.R. Greenberg

Departments of Medicine, University of Toronto and Toronto General Hospital, Toronto, Canada

K.N. Jeejeebhoy

Departments of Medicine, University of Toronto and Toronto General Hospital, Toronto, Canada

The role of parenteral nutrition with complete bowel rest in the management of active Crohn's disease was evaluated retrospectively in 100 patients who were otherwise refractory to conventional medical management. Ninety patients received complete nutrient replacement and 10 received protein-sparing therapy. In 77 patients, a clinical remission was achieved. Analysis of subgroups revealed that the remission rate was equivalent in patients with subacute bowel obstruction (76%), inflammatory mass (82%), and otherwise uncomplicated severe active disease (89%). However, those patients with fistulae responded less well (63%). The location of the intestinal involvement with the disease did not influence the remission rate (73% in those with small bowel disease only and 78% in those with combined small and large bowel disease). All six patients with only large bowel involvement achieved a remission. In 81% of those patients with a remission, no corticosteroids were given, or the dose prior to TPN was maintained. The serum albumin improved significantly (p < 0.001) from 3.2 ± 0.1 to 3.6 ± 0.1 g/dl with total parenteral nutrition, but there was no significant effect on the hematocrit (p > 0.5). The percentage of patients still in remission after 3 months and 1 yr of follow-up was 75 to 79 and 58 to 61 % , respectively, in the three nonfistulous groups, and 46 and 36%, respectively, in those with fistulous disease. Thus total parenteral nutrition with complete bowel rest appears to be an effective therapeutic modality in the primary management of complicated Crohn's disease. (Journal of Parenteral and Enteral Nutrition 9:280-287, 1985)

Journal of Parenteral and Enteral Nutrition, Vol. 9, No. 3, 280-287 (1985)
DOI: 10.1177/0148607185009003280


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. M. Wiese, R. Rivera, and D. L. Seidner Is There a Role for Bowel Rest in Nutrition Management of Crohn's Disease? Nutr Clin Pract, June 1, 2008; 23(3): 309 - 317. [Abstract] [Full Text] [PDF]

				M J Carter, A J Lobo, and S P L Travis Guidelines for the management of inflammatory bowel disease in adults Gut, September 1, 2004; 53(suppl_5): v1 - v16. [Full Text] [PDF]

				K. N. Jeejeebhoy Clinical nutrition: 6. Management of nutritional problems of patients with Crohn's disease Can. Med. Assoc. J., April 1, 2002; 166(7): 913 - 918. [Full Text] [PDF]

				D. Royall, G. R. Greenberg, J. P. Allard, J. P. Baker, and K. N. Jeejeebhoy Total Enteral Nutrition Support Improves Body Composition of Patients With Active Crohn's Disease JPEN J Parenter Enteral Nutr, March 1, 1995; 19(2): 95 - 99. [Abstract] [PDF]

				M. D. Sitrin Invented Review: Nutrition Support in Inflammatory Bowel Disease Nutr Clin Pract, April 1, 1992; 7(2): 53 - 60. [Abstract] [PDF]