Enteral nutrition decreases hospitalization rate in patients with Crohn's disease.
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.
Watanabe
Osamu
O
Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ando
Takafumi
T
Ishiguro
Kazuhiro
K
Takahashi
Hironao
H
Ishikawa
Daisuke
D
Miyake
Nobuyuki
N
Kato
Tsuyoshi
T
Hibi
Satoshi
S
Mimura
Shunya
S
Nakamura
Masanao
M
Miyahara
Ryoji
R
Ohmiya
Naoki
N
Niwa
Yasumasa
Y
Goto
Hidemi
H
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