Peripheral parenteral nutrition is no better than enteral nutrition in acute exacerbation of Crohn's disease: a prospective trial.
The use of parenteral nutrition in patients with exacerbation of regional enteritis is controversial, the clinical dictum being bowel rest and nutritional repletion. In order to address this issue, on the short-term at least, a prospective randomized trial compared peripheral parenteral alimentation and elemental feedings for 2 weeks in patients hospitalized with regional enterities. Both groups had significant objective clinical improvement on their respective nutritional supplementation regimens pre- versus posttherapy as assessed by the Crohn's Disease Activity Index (CDAI) (p less than 0.05). However, there was no significant difference in improvement between parenteral versus enteral groups as assessed by the CDAI. Changes in nutritional assessment parameters, including retinol binding protein, nitrogen balance, total lymphocyte count, and transferrin, were related to the quantity of calories consumed rather than the mode of delivery. A positive nitrogen balance was obtained in all patients despite weight loss in the majority. The route of nutrient delivery in acute exacerbation of regional enteritis does not appear to have an impact on the short-term outcome.
Wright
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RA
Department of Medicine, University of Louisville School of Medicine, Kentucky.
Adler
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EC
D000328:Adult; D003424:Crohn Disease / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011446:Prospective Studies; D012177:Retinol-Binding Proteins / Q000096:biosynthesis; D014168:Transferrin / Q000096:biosynthesis; D015430:Weight Gain
D012177:Retinol-Binding Proteins; D014168:Transferrin