[Cyclic enteral nutrition and Crohn's disease localized in the distal ileum and/or the colon. Trial of a dietary polymer mixture].
Cyclic enteral nutrition (CEN) is a technique regularly used during the active phases of CDIC. Elemental or semi-elemental diets are usually employed. We tested the tolerance and efficacy of a ternary polymeric diet for nightly administration on a discontinuous basis (Polydiet). CEN was given to 12 malnourished patients with active CDIC of moderate intensity (6-9 Harvey Bradshaw Index). Corticosteroid therapy with prednisolone (0.3 to 0.9 mg/kg) was given in combination in 6 patients throughout the course of CEN. Duration of CEN, energy and protein intake, age, sex, degree of activity of CDIC and lesional extent, and percentage of malnutrition were comparable in both groups of patients. In all cases, clinical tolerance was remarkable allowing therapy to be maintained. No significant change in laboratory test values of hepatic or renal functions or of plasma lipids occurred. A positive significant variation was noted in both groups for the following parameters: body weight (p less than 0.01); muscle circumference (p less than 0.001); serum albumin (p less than 0.001), transferrin (p less than 0.01), clinical score (p less than 0.001). Triceps skin fold and lymphocyte count did not vary significantly. Corticosteroid therapy at the above dosage did not alter these parameters. Positive maintenance of nitrogen balance was obtained in all cases at the end of the first week of CEN.


CONCLUSIONS
With equivalent nutritional value and for a lower cost, polymeric diets could be used more frequently in the treatment of CDIC. Tolerance and correction of nutritional disorders appear comparable to elemental products if lesions affect only the distal small intestine and/or colon.
Gineston
J L
JL
Service d'Hépato-Gastroentérologie, Centre Hospitalier et Universitaire, Amiens.
Davion
T
T
Favi
M
M
D000293:Adolescent; D000328:Adult; D003092:Colitis / Q000628:therapy; D003424:Crohn Disease / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007079:Ileitis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000627:therapeutic use
D011108:Polymers
Nutrition entérale cyclique et maladie de Crohn à localisation iléale distale et/ou colique. Essai d'un mélange diététique polymérique.