Parenteral Nutrition Use in Ulcerative Colitis

Abstract

Total parenteral nutrition (TPN) is the provision of all known essential dietary substances. Parenteral nutrition (PN) is indicated when a patient is unable to consume sufficient nutrients and fluid necessary to maintain normal nutritional and hydration status or correct undernutrition and the gastrointestinal tract is either nonfunctional or not sufficiently functional as to allow sufficient oral consumption of nutrients and fluid or the administration of sufficient quantities of nutrient and fluid via a feeding tube. The use of TPN does not appear to have clinical benefit as a primary means for induction of remission in patients with UC but may be a useful adjunct for toxic megacolon or patients who are otherwise unable to eat because of severe abdominal cramping. There appears to be no additional benefit from PN itself in patients with UC who are otherwise able to eat or to receive enteral nutritional support. The use of PN in patients with UC has been associated with increased mortality after adjustment for age, sex, comorbidity, health insurance, and geographic location and whether the hospital where they were hospitalized was urban/rural and teaching/nonteaching or whether the facility was small or large.