title: Enteral nutrition decreases hospitalization rate in patients with Crohn's disease.
abstract: OBJECTIVE
  Crohn's disease (CD) is a chronic inflammatory bowel disease with relapse and remission. CD patients are admitted to hospital when bowel inflammation flares up severely, which lowers their quality of life. Enteral nutrition (EN) with an elemental diet plays an important role in the treatment for CD patients in Japan, because of its few adverse effects, and it is thought to be effective in maintaining remission. We investigated the effectiveness of EN with an elemental diet with regard to the avoidance of hospitalization.
  
  
  METHODS
  A total of 268 patients with CD who visited hospital from 2003-2008 were enrolled. The relationship between the caloric content of an elemental diet and hospitalization as an end-point was examined retrospectively using Cox regression analysis. Cumulative non-hospitalization rates were calculated by the Kaplan-Meier method.
  
  
  RESULTS
  Of the 268 patients, 155 received an elemental diet providing 900 kcal/day or more. Among 237 patients with ileal involvement, 135 patients receiving an elemental diet providing 900 kcal/day or more showed a statistically significant improvement in cumulative non-hospitalization rate. Among 31 patients without ileal involvement, in contrast, the cumulative non-hospitalization rate did not differ among those receiving an elemental diet of less or more than 900 kcal/day.
  
  
  CONCLUSIONS
  The use of an elemental diet of 900 kcal/day may be effective in avoiding hospitalization in CD patients with ileal lesions. This diet may be useful in improving the long-term convalescence of these patients.
authors.affiliation: Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ando
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishiguro
authors.forename: Hironao
authors.initials: H
authors.lastname: Takahashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ishikawa
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Miyake
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hibi
authors.forename: Shunya
authors.initials: S
authors.lastname: Mimura
authors.forename: Masanao
authors.initials: M
authors.lastname: Nakamura
authors.forename: Ryoji
authors.initials: R
authors.lastname: Miyahara
authors.forename: Naoki
authors.initials: N
authors.lastname: Ohmiya
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000473:pathology / Q000628:therapy*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D005526:Food, Formulated; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007082:Ileum / Q000473:pathology; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome