[Enteral nutrition in severe ulcerative colitis. Digestive tolerance and nutritional efficiency].
OBJECTIVE
Total parenteral nutrition (TPN) has been traditionally used as an adjunctive therapy in severe ulcerative colitis patients. We performed a prospective study to ascertain the safety, nutritional efficiency, tolerance and costs of total enteral nutrition in this situation.


METHODS
After 48 hours of intensive medical treatment, severe ulcerative colitis patients initiated enteral feeding with a polymeric formula. The formula concentration and volume were increased daily.


RESULTS
17 patients (7 women, 10 men; age 36.8 +/- 12.8 years) with a mean clinical activity score of 15.6 +/- 1.5 were included. In 14 patients (82.4%) enteral nutrition was well tolerated, attaining in 11 of them more than 80% of the caloric requirements by day 4. In 3 cases we observed vomiting and bloating. Prealbumin levels improved significantly from 11.1 +/- 3.4 mg/dl to 22.7 +/- 6.8 mg/dl (p = 0.002) at the end of enteral nutrition (11.8 +/- 4.7 days). Albumin and other nutritional parameters did not change.


CONCLUSIONS
Total enteral nutrition could be considered a safe and well tolerated nutritional support in these patients. Although albumin and other nutritional parameters did not change during the study period, the increase in prealbumin levels suggests a favourable anabolic effect of total enteral nutrition.
Klaassen
J
J
Departamentos de Nutrición, Gastroenterología y Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Zapata
R
R
Mella
J G
JG
Aguayo
G
G
Alvarado
D
D
Espinosa
O
O
Maíz
A
A
Zúñiga
A
A
Quintana
C
C
D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000191:economics / Q000628:therapy*; D004750:Enteral Nutrition / Q000191:economics; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index
D012709:Serum Albumin
Nutrición enteral en crisis grave de colitis ulcerosa: efectividad nutricional y tolerancia digestiva.