[Clinical efficacy of enteral nutrition in inflammatory bowel diseases].
Undernutrition with weight loss, protein deficiency and specific deficiencies in vitamins, and trace elements are common in the acute phase of IBD. Anorexia, increased intestinal losses and systemic inflammation are the main causes of undernutrition. The relevance and extent of these deficiencies vary according to the site and extent of diseased intestine as well as disease activity. Mechanisms of EN efficacy as a primary treatment of IBD are not revealed yet. However, most physicians start to be earnest about enteral feeding because this treatment method does not cause any serious or prolonged complications. There are no significant differences in the effect of free amino acid, peptide-based and whole protein formulae for EN in IBD. Nutritional support with normal food is considered the treatment of choice. This article gives recommendations for the indication, application and type of formula of EN (oral nutritional supplements (ONS) or tube feeding (TF)) in patients with IBD. These are based on all relevant publications since 1995 and own authors experience. ONS and/or TF in addition to normal food is indicated in undernourished patients with IBD to improve nutritional status and quality of life. In active IBD EN should be used as sole therapy in adults mainly when treatment with corticosteroids is not feasible, e.g. due to intolerance or refusal. Combined therapy (EN and drugs) is indicated in undernourished patients as well as in those with inflammatory stenosis of the intestine. With ONS, a supplementary intake of up to 600 kcal/day can be achieved in addition to normal food. If a higher intake is required, TF is necessary. TF can be safely delivered by the nasogastric tube (NGT). Continuous administration of TF rather than bolus delivery is preferred because of the lower complication. In remission of IBD ONS and/or TF are recommended.
Osina
V A
VA
Kuz'mina
T N
TN
Sil'vestrova
S Iu
SIu
Petrakov
A V
AV
D000465:Algorithms; D004734:Energy Metabolism; D004750:Enteral Nutrition; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D010288:Parenteral Nutrition; D011788:Quality of Life