Home elemental enteral hyperalimentation (HEEH) for the maintenance of remission in patients with Crohn's disease.
Since specific treatment has not yet been decided on for Crohn's disease, the immediate target is the induction of remission and its maintenance. We examined the effects of an elemental diet (ED) in Crohn's disease with special reference to the maintenance of remission. Eighty-four patients received total enteral nutrition with the ED (35 to 40 kcal/kg ideal body weight/day) and/or conventional drug treatment for induction of remission. Sixty-one patients in remission were then followed-up with prolonged ED therapy (home elemental enteral hyperalimentation, HEEH) and/or drugs. During the follow-up periods the course of patients receiving HEEH was better than those of patients without HEEH, namely the cumulative continuous remission rates after one, 2 and 4 years were, 94%, 63% and 63% in the group receiving HEEH, 75%, 66% and 66% in the group receiving HEEH and drugs, 63%, 42% and 0% in the group receiving drugs, and 50%, 33% and 0% in the group receiving no maintenance therapy, respectively. In particular, when more than 30 kcal/kg ideal body weight/day of the ED was given, the maintenance of remission was successful in 95% of the patients. These results indicated that ED therapy was effective not only for the induction of remission but also for the maintenance of remission in Crohn's disease.
Hirakawa
H
H
Fourth Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Fukuda
Y
Y
Tanida
N
N
Hosomi
M
M
Shimoyama
T
T
D000328:Adult; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000453:epidemiology / Q000628:therapy*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D005526:Food, Formulated; D006699:Home Care Services; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012460:Sulfasalazine / Q000627:therapeutic use; D013997:Time Factors
D012460:Sulfasalazine; D011239:Prednisolone