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Enteral nutrition for maintaining remission in patients with quiescent Crohn’s disease: current status and future perspectives

International Journal of Colorectal Disease volume 31, pages 1–7 (2016)Cite this article

ABSTRACT

Purpose

The value of enteral nutrition (EN) as maintenance therapy in patients with quiescent Crohn’s disease (CD) has not been fully evaluated. The purpose of this study was to review the efficacy of EN for the maintenance of remission in patients with quiescent CD.

Methods

Seven prospective cohort studies evaluating the efficacy of EN for the maintenance of remission in quiescent CD were included. Three of the seven studies were randomized-controlled trials (RCTs). In all studies, patients used EN as a supplement or as a nocturnal tube feeding in addition to their normal food.

Results

One study compared the efficacy of elemental diet and polymeric diet. Elemental and polymeric diets were equally effective for the maintenance of clinical remission and for allowing tapering and cessation of steroid therapy. The other six studies compared the outcomes between patients treated with and without EN. The maintained clinical remission rate at 1 year was significantly higher in patients treated with EN in four of the six studies. Quantitative pooling of the studies was not feasible due to a small number of RCTs and a narrative account of the study characteristics.

Conclusions

Our review suggests that EN is useful for the maintenance of remission in patients with quiescent CD. However, there are several limitations in the reviewed studies. There are few RCTs. Further, the sample size is small, and the duration of intervention and follow-up is short. Large and well-designed RCTs should be conducted to rigorously evaluate the efficacy of EN for maintaining remission.

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Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan

    Maki Nakahigashi & Fumio Kobayashi

  2. Faculty of Health Sciences, Suzuka University of Medical Science, Suzuka, Japan

    Maki Nakahigashi

  3. Inflammatory Bowel Disease Center, Yokkaichi Hazu Medical Center, 10-8 Hazuyamacho, Yokkaichi, Mie, 510-0016, Japan

    Takayuki Yamamoto

  4. Department of Gastroenterology, Pisa University Hospital, Pisa, Italy

    Rodolfo Sacco

  5. Center for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital, Hamamatsu, Japan

    Hiroyuki Hanai

Authors
  1. Maki Nakahigashi
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  2. Takayuki Yamamoto
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  3. Rodolfo Sacco
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  4. Hiroyuki Hanai
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  5. Fumio Kobayashi
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Correspondence to Takayuki Yamamoto.

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Nakahigashi, M., Yamamoto, T., Sacco, R. et al. Enteral nutrition for maintaining remission in patients with quiescent Crohn’s disease: current status and future perspectives. Int J Colorectal Dis 31, 1–7 (2016). https://doi.org/10.1007/s00384-015-2348-x

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  • DOI: https://doi.org/10.1007/s00384-015-2348-x

Keywords

  • Crohn’s disease
  • Elemental diet
  • Enteral nutrition
  • Maintenance therapy
  • Remission