Impact of long-term enteral nutrition on clinical and endoscopic recurrence after resection for Crohn's disease: A prospective, non-randomized, parallel, controlled study.
BACKGROUND
The impact of enteral nutrition on post-operative recurrence has not been properly examined.


OBJECTIVE
To investigate the impact of enteral nutrition using an elemental diet on clinical and endoscopic recurrence after resection for Crohn's disease.


METHODS
Forty consecutive patients who underwent resection for ileal or ileocolonic Crohn's disease were studied. After operation, 20 patients continuously received enteral nutritional therapy (EN group), and 20 had neither nutritional therapy nor food restriction (non-EN group). In the EN group, enteral formula (Elental) was infused through a nasogastric tube in the night-time, and low fat foods were taken in the daytime. All patients were followed up regularly for 1 year after operation. Ileocolonoscopy was performed at 6 and 12 months after operation.


RESULTS
One patient (5%) in the EN group and seven (35%) in the non-EN group developed clinical recurrence during 1-year follow-up (P = 0.048). Six months after operation, five patients (25%) in the EN group and eight (40%) in the non-EN group developed endoscopic recurrence (P = 0.50). Twelve months after operation, endoscopic recurrence was observed in six patients (30%) in the EN group and 14 (70%) in the non-EN group (P = 0.027).


CONCLUSIONS
Our long-term enteral nutritional therapy significantly reduced clinical and endoscopic recurrence after resection for Crohn's disease.
Yamamoto
T
T
Inflammatory Bowel Disease Centre & Department of Surgery, Yokkaichi Social Insurance Hospital, Yokkaichi, Mie, Japan. nao-taka@sannet.ne.jp
Nakahigashi
M
M
Umegae
S
S
Kitagawa
T
T
Matsumoto
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000178:diet therapy* / Q000517:prevention & control; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome