ENTERAL NUTRITION AS PRIMARY THERAPY IN CROHNS-DISEASE

被引:50
作者
FERNANDEZBANARES, F [1 ]
CABRE, E [1 ]
GONZALEZHUIX, F [1 ]
GASSULL, MA [1 ]
机构
[1] HOSP UNIV GERMANS TRIAS & PUJOL, DEPT GASTROENTEROL, E-08916 BADALONA, SPAIN
关键词
D O I
10.1136/gut.35.1_Suppl.S55
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The developments in enteral feeding for Crohn's disease in the past decade are critically reviewed. The advent of amino acid based chemically defined elemental diets signalled the end of 'total bowel rest' in the management of these patients. Subsequently, controlled clinical trials showed that elemental diets were as effective as corticosteroids in inducing clinical remission in patients with acute exacerbations of Crohn's disease. The later use of peptide based elemental diets, in Crohn's disease produced somewhat conflicting results. The initial uncontrolled studies suggest that polymeric whole protein diets might also be effective in the management of acute exacerbations of the disease, casting in turn doubts concerning the role of dietary antigens in the pathogenesis of Crohn's disease. Results of controlled studies comparing the use of elemental and polymeric diets as primary therapy in Crohn's disease have, however, also produced conflicting results. The results of one recent controlled trial in which the use of polymeric diet was compared with that of corticosteroids does, however, suggest that these diets may have a primary therapeutic effect in Crohn's disease. An analysis of the composition of some of the enteral diets used in different trials suggest that the effectiveness of enteral diets in treating active Crohn's disease might relate more to their fat than nitrogen composition. A hypothesis is proposed that the effectiveness of enteral nutrition in the primary therapy of acute exacerbations of Crohn's disease occurs because the successful diets used contain insufficient precursors for arachidonate derived eicosanoid synthesis.
引用
收藏
页码:S55 / S59
页数:5
相关论文
共 49 条
  • [1] BAROT LR, 1981, ARCH SURG-CHICAGO, V116, P460
  • [2] BEST WR, 1976, GASTROENTEROLOGY, V70, P439
  • [3] Bodemar G, 1991, J CLIN NUTR GASTROEN, V6, P75
  • [4] COYLE B L, 1989, Journal of Human Nutrition and Dietetics, V2, P25, DOI 10.1111/j.1365-277X.1989.tb00004.x
  • [5] ARE ACTIVITY INDEXES HELPFUL IN ASSESSING ACTIVE INTESTINAL INFLAMMATION IN CROHNS-DISEASE
    CRAMABOHBOUTH, G
    PENA, AS
    BIEMOND, I
    VERSPAGET, HW
    BLOK, D
    ARNDT, JW
    WETERMAN, IT
    PAUWELS, EKJ
    LAMERS, CBHW
    [J]. GUT, 1989, 30 (09) : 1236 - 1240
  • [6] IOIBD .1. OBSERVER VARIATION IN CALCULATING INDEXES OF SEVERITY AND ACTIVITY IN CROHNS-DISEASE
    DEDOMBAL, FT
    SOFTLEY, A
    [J]. GUT, 1987, 28 (04) : 474 - 481
  • [7] MODIFICATION OF ADJUVANT INFLAMMATION IN RATS DEFICIENT IN ESSENTIAL FATTY-ACIDS
    DENKO, CW
    [J]. AGENTS AND ACTIONS, 1976, 6 (05): : 636 - 641
  • [8] TOTAL PARENTERAL NUTRITION IN INFLAMMATORY BOWEL-DISEASE
    DRISCOLL, RH
    ROSENBERG, IH
    [J]. MEDICAL CLINICS OF NORTH AMERICA, 1978, 62 (01) : 185 - 201
  • [9] THE EFFECT OF DIETARY SUPPLEMENTATION WITH N-3 POLY-UNSATURATED FATTY-ACIDS ON THE SYNTHESIS OF INTERLEUKIN-1 AND TUMOR NECROSIS FACTOR BY MONONUCLEAR-CELLS
    ENDRES, S
    GHORBANI, R
    KELLEY, VE
    GEORGILIS, K
    LONNEMANN, G
    VANDERMEER, JWM
    CANNON, JG
    ROGERS, TS
    KLEMPNER, MS
    WEBER, PC
    SCHAEFER, EJ
    WOLFF, SM
    DINARELLO, CA
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1989, 320 (05) : 265 - 271
  • [10] PLASMA POLYUNSATURATED FATTY-ACID PATTERN IN ACTIVE INFLAMMATORY BOWEL-DISEASE
    ESTEVECOMAS, M
    RAMIREZ, M
    FERNANDEZBANARES, F
    ABADLACRUZ, A
    GIL, A
    CABRE, E
    GONZALEZHUIX, F
    MORENO, J
    HUMBERT, P
    GUILERA, M
    BOIX, J
    GASSULL, MA
    [J]. GUT, 1992, 33 (10) : 1365 - 1369