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An Evaluation of Total Parenteral Nutrition in the Management of Steroid‐dependent and Steroid‐resistant Patients with Crohn's Disease
Author(s) -
Lerebours E.,
Messing B.,
Chevalier B.,
Bories C.,
Colin R.,
Bernier J.J.
Publication year - 1986
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607186010003274
Subject(s) - medicine , parenteral nutrition , crohn's disease , fistula , surgery , disease , gastroenterology , medical therapy , abscess , population , environmental health
This study is an evaluation of short‐ and long‐term benefits of total parenteral nutrition (TPN) in 20 patients with active Crohn's disease but without fistulae. TPN was done during 42 (14–80) days (median‐range) after failure of medical therapy including patients with steroid‐resistant (11 SR) or steroid‐dependent (9 SD) active Crohn's disease. Efficacy of short‐term TPN was demonstrated by nutritional repair and achievement of clinical remission in all but one patients. Follow‐up was 28 (8–78) months in the 19 patients (10 SR, 9 SD) discharged improved after the end of TPN. At 1 yr, the cumulative recurrence rate was 26% (5/19). During the follow‐up, three patients (2 SR, 1 SD) remained symptom‐free, 13 (6 SR, 7 SD) had a partial remission defined as relapse controlled by medication, and only three patients (2 SR, 1 SD) had a relapse uncontrolled by medical therapy leading to surgery. Therefore in our selected population without fistula or abscess, after failure of medical therapy TPN was obviously an effective therapy which avoided surgery. Furthermore follow‐up indicated that SD and SR were only transient events in the course of Crohn's disease patients. ( Journal of Parenteral and Enteral Nutrition 10 :274–278, 1986)