Home parenteral nutrition in chronic intestinal diseases: its effect on growth and development.
Nine children and adolescents with chronic intestinal diseases and growth failure were treated with home parenteral nutrition (HPN) for 7-63 months. All patients improved their growth velocities on HPN, with an average height gain of 9 cm. The mean growth velocity in six patients with Crohn's disease increased more than fivefold (from 0.67 +/- 0.4 cm/year to 3.8 +/- 1.09 cm/year), and they gained a mean of 11.4 +/- 3.4 kg/year. The three patients without Crohn's disease [intestinal pseudo-obstruction (two), severe short bowel (one)] increased growth velocity from an average of 2.9 +/- 1.1 cm to 6.1 +/- 1.34 cm/year and gained a mean of 10 +/- 2.84 kg/year. Patients without Crohn's disease grew faster on HPN than age comparable patients with Crohn's disease. Also, the two patients with Crohn's disease who were younger and had their disease for a shorter period (less than 3 years) grew better than older patients with Crohn's disease who had their disease for a mean of 8 +/- 1.3 years. All patients improved clinically, and three with Crohn's disease achieved complete remission. Five of the nine patients had psychosocial adjustment problems while on HPN. In conclusion, HPN is a relatively safe and effective means to stimulate growth in children and adolescents who cannot meet nutritional needs by the enteral route.
D000293:Adolescent; D000328:Adult; D001827:Body Height; D001835:Body Weight; D002648:Child; D002908:Chronic Disease; D003424:Crohn Disease / Q000628:therapy; D006130:Growth Disorders / Q000209:etiology / Q000503:physiopathology; D006699:Home Care Services; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D007418:Intestinal Pseudo-Obstruction / Q000628:therapy; D010288:Parenteral Nutrition; D012741:Sexual Maturation; D012778:Short Bowel Syndrome / Q000628:therapy