Skip to main content
SpringerLink
Log in

Progress in nutritional management of patients with Crohn’s disease

  • Chapter
Clinical Research in Gastroenterology 2

  • 41 Accesses

Abstract

As with many other diseases of the gastrointestinal tract there have been several attempts to treat patients with Crohn’s disease with nutritional therapy. If one analyses these attempts one can find three different approaches:

(1) It was hypothesized that Crohn’s disease is caused by special dietary habits and therefore changing of these habits should avoid or heal Crohn’s disease. Consequently special diets were recommended for patients with inactive Crohn’s disease.

(2) Patients with Crohn’s disease clearly experience food-dependent symptoms. Therefore parenteral and enteral nutrition regimens have been used to avoid these symptoms. Different investigators observed that parenteral and enteral nutrition not only have a symptomatic effect but may also be a primary treatment in the acute phase of Crohn’s disease.

(3) Crohn’s disease leads in a good proportion of patients to nutritional deficiencies which may be caused by malabsorption due to high disease activity or multiple intestinal resections or by anorexia because of food-dependent symptoms. These malnourished patients have to be treated nutritionally regardless of whether the disease is active or inactive.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Mayberry, J.F. and Rhodes, J. (1984). Epidemiological aspects of Crohn’s disease: a review of the literature. Gut, 25, 886–99

    Article  PubMed  CAS  Google Scholar 

  2. Acheson, E.D. (1960). The distribution of ulcerative colitis and regional enteritis in United States veterans with particular reference to the Jewish religion. Gut, 1, 291–3

    Article  PubMed  CAS  Google Scholar 

  3. Lorenz-Meyer, H. and Brandes, J.W. (1983). Gibt es eine diätetische Behandlung des Morbus Crohn in der Remission? Dtsch. Med. Wschr., 108, 595–7

    PubMed  CAS  Google Scholar 

  4. Martini, G.A. and Brandes, J.W. (1976). Increased consumption of refined carbohydrates in patients with Crohn’s disease. Klin. Wschr., 54, 367

    Article  PubMed  CAS  Google Scholar 

  5. Miller, B., Fevers, F., Rhobeck, R. et al. (1976). Zuckerkonsum bei Patienten mit Morbus Crohn. Verh. Dtsch. Ges. Inn. Med., 82, 922

    PubMed  Google Scholar 

  6. James, A.H. (1977). Breakfast and Crohn’s disease. Br. Med. J., 1, 943

    Article  PubMed  CAS  Google Scholar 

  7. Rawcliffe, P.M. and Truelove, S.C. (1978). Breakfast and Crohn’s disease. II. Br. Med. J., 2, 539

    Article  PubMed  CAS  Google Scholar 

  8. Thornton, J.R., Emmet, P.M. and Heaton, K.W. (1979). Diet and Crohn’s disease. Characteristics of the pre-illness diet. Br. Med. J., 2, 762

    Article  PubMed  CAS  Google Scholar 

  9. Kasper, H. and Sommer, H. (1979). Dietary fiber and nutrient intake in Crohn’s disease. Am. J. Clin. Nutr., 32, 1898

    PubMed  CAS  Google Scholar 

  10. Mayberry, J.F., Rhodes, J. and Newcombe, R.G. (1980). Increased sugar consumption in Crohn’s disease. Digestion, 20, 323

    Article  PubMed  CAS  Google Scholar 

  11. Silkoff, K., Hallak, A., Yegena, L. et al. (1980). Consumption of refined carbohydrate by patients with Crohn’s disease in Tel-Aviv-Yafo. Postgrad. Med. J., 36, 842

    Article  Google Scholar 

  12. Mayberry, J.F., Rhodes, J„ Allan, R. et al. (1981). Diet in Crohn’s disease. Two studies of current and previous habits in newly diagnosed patients. Dig. Dis. Sci., 26, 444–8

    Article  PubMed  CAS  Google Scholar 

  13. Naujoks-Heinrich, S., Grossmann, E., Gottschalk, S. et al. (1982). Dietary habits in Crohn’s disease. Second Symposium on Crohn’s Disease, Hemmenhofen, 1982

    Google Scholar 

  14. Järnerot, G., Järnmark, I. and Nilsson, K. (1983). Consumption of refined sugar by patients with Crohn’s disease, ulcerative colitis, or irritable bowel syndrome. Scand. J. Gastroenterol., 18, 999–1002

    Article  PubMed  Google Scholar 

  15. Guthy, E. (1983). Ätiologie des Morbus Crohn. Was spricht für Fette als mögliche Ursache? Dtsch. Med. Wschr., 108, 1729–33

    Article  PubMed  CAS  Google Scholar 

  16. Brandes, J.W. and Lorenz-Meyer, H. (1981). Zuckerfreie Diät: Eine neue Perspektive zur Behandlung des Morbus Crohn. Eine randomisierte kontrollierte Studie. Z. Gastroenterol., 19, 1–12

    PubMed  CAS  Google Scholar 

  17. Ritchie, J.K., Wadsworth, J., Lennard-Jones, J.E. et al. (1987). Controlled multicentre therapeutic trial of an unrefined carbohydrate, fibre rich diet in Crohn’s disease. Br. Med. J., 295, 517–20

    Article  CAS  Google Scholar 

  18. Jones, VA., Workman, E., Freeman, A.H. et al. (1985). Crohn’s disease: Maintenance of remission by diet. Lancet, 2, 177–80

    Article  PubMed  CAS  Google Scholar 

  19. Jones, VA. (1987). Comparison of total parenteral nutrition and elemental diet in induction of remission of Crohn’s disease. Long-term maintenance of remission by personalized food exclusion diets. Dig. Dis. Sci., 32, 100S–107S

    Article  PubMed  CAS  Google Scholar 

  20. Driscoll, R.H. and Rosenberg, I.H. (1978). Total parenteral nutrition in inflammatory bowel disease. Med. Clin. North Am., 62, 185–201

    PubMed  Google Scholar 

  21. Morin, C.L., Roulet, M., Roy, C.C. et al. (1980). Continuous elemental enteral alimentation in children with Crohn’s disease and growth failure. Gastroenterology, 79, 1205–10

    PubMed  CAS  Google Scholar 

  22. Peters, H. (1976). Parenteral-perorale Kombinationsbehandlung von Morbus Crohn und Colitis ulcerosa. Infusionstherapie, 3, 222–6

    CAS  Google Scholar 

  23. Fromm, H., Gebel, M., Schroeter, U. (1978). Zur Behandlung des Morbus Crohn im akuten Stadium. Dtsch. Med. Wschr., 9, 377–80

    Article  Google Scholar 

  24. Dickinson, R.J., Ashton, M.G., Axon, A.T.R. et al. (1980). Controlled trial of intravenous hyperalimentation and total bowel rest as an adjunct of the routine therapy of acute colitis. Gastroenterology, 79, 1199–204

    PubMed  CAS  Google Scholar 

  25. Kirschner, B.S., Klich, J.R., Kaiman, S. et al. (1981). Reversal of growth retardation in Crohn’s disease with therapy emphasizing oral nutrition restitution. Gastroenterology, 80, 10–15

    PubMed  CAS  Google Scholar 

  26. Meryn, S, Lochs, H., Rötzi, R. et al. (1982). Einfluss von parenteraler Ernährung auf Serumproteine bei Patienten mit Morbus Crohn. Infusionstherapie, 9, 149–52

    CAS  Google Scholar 

  27. Morin, C.L., Roulet, M., Ray, C.C. et al. (1982). Continuous elemental enteral alimentation in the treatment of children and adolescents with Crohn’s disease. J. Parent. Ent. Nutr., 6, 194–9

    Article  CAS  Google Scholar 

  28. Lochs, H., Meryn, S., Marosi, L. et al. (1983). Has total bowel rest a beneficial effect in the treatment of Crohn’s disease? Clin. Nutr., 2, 61–74

    Article  PubMed  CAS  Google Scholar 

  29. Müller, J.M., Keller, H.W., Erasmi, H. et al. (1983). Total parenteral nutrition as the sole therapy in Crohn’s disease — a prospective study. Br. J. Surg., 70, 40–3

    Article  PubMed  Google Scholar 

  30. Lochs, H., Egger-Schödl, M., Schuh, R. et al. (1984). Is tube feeding with elemental diets a primary therapy of Crohn’s disease? Klin. Wschr., 237, 1–5

    Google Scholar 

  31. Ostro, M.J., Greenberg, G.R. and Jeejeebhoy, K.N. (1985). Total parenteral nutrition and complete bowel rest in the management of Crohn’s disease. J. Parent. Ent. Nutr., 9, 280–7

    Article  CAS  Google Scholar 

  32. Lerebours, E., Messing, B., Chevalier, B. et al. (1986). An evaluation of total parenteral nutrition in the management of steroid-dependent and steroid-resistant patients with Crohn’s disease. J. Parent. Ent. Nutr., 10, 274–8

    Article  CAS  Google Scholar 

  33. Rabast, U. and Heskamp, R. (1986). Adjuvante Therapie mit Formeldiäten bei chronischentzündlichen Darmerkrankungen. Dtsch. Med. Wschr., 111, 293–7

    Article  PubMed  CAS  Google Scholar 

  34. Greenberg, G.R., Fleming, C.R., Jeejeebhoy, K.N. et al. (1988). Controlled trial of bowel rest and nutritional support in the management of Crohn’s disease. Gut, 29, 1309–15

    Article  PubMed  CAS  Google Scholar 

  35. Lochs, H., Steinhardt, H.J., Klaus-Wenz, B. et al. (1988). Enteral nutrition versus drug treatment for the acute phase of Crohn’s disease: Results of the European Co-operative Crohn’s Disease Study IV. Gastroenterology, 94, A267

    Google Scholar 

  36. Motil, K.J., Grand, R.J., Matthews, D.E. et al. (1982). Whole body leucine metabolism in adolescents with Crohn’s disease and growth failure during nutritional supplementation. Gastroenterology, 82, 1359–68

    PubMed  CAS  Google Scholar 

  37. Higgens, C.S., Keighley, M.R.B. and Allan, R.N. (1984). Impact of preoperative weight loss and body composition changes on postoperative outcome in surgery for inflammatory bowel disease. Gut, 25, 732–6

    Article  PubMed  CAS  Google Scholar 

  38. Lindon, K.D., Fleming, C.R. and Ilstrup, D.M. (1985). Preoperative nutritional status and other factors that influence surgical outcome in patients with Crohn’s disease. Mayo Clin. Proc., 60, 393–6

    Google Scholar 

  39. MacFayden, B.V., Jr., Dudrick, S.J. and Ruberg, R.L. (1973). Management of gastrointestinal fistulas with parenteral hyperalimentation. Surgery, 74, 100–5

    Google Scholar 

  40. Meryn, S., Lochs, H., Pamperl, H. et al. (1983). Influence of parenteral nutrition on serum levels of proteins in patients with Crohn’s disease. J. Parent. Ent. Nutr., 7, 553–6

    Article  CAS  Google Scholar 

  41. Harries, A.D., Danis, V., Heatley, R.V. et al. (1983). Controlled trial of supplemented oral nutrition in Crohn’s disease. Lancet, 1, 887–90

    Article  PubMed  CAS  Google Scholar 

  42. Jones, B.J.M. (1986). Enteral feeding: techniques of administration. Gut, 27, (S1), 47–50

    Article  PubMed  Google Scholar 

  43. Jones, B.J.M., Payne, S. and Silk, D.BA. (1980). Indications for pump-assisted enteral feeding. Lancet, 2, 1057–8

    Article  Google Scholar 

  44. Silk, D.BA. (1986). Diet formulation and choice of enteral diet. Gut, 27, (S1), 40–6

    Article  PubMed  CAS  Google Scholar 

  45. Moriarty, K.J., Hegarty, J.E., Fairclough, P.D. et al. (1985). Relative nutritional value of whole protein, hydrolysed protein and free amino acids in man. Gut, 26, 694–9

    Article  PubMed  CAS  Google Scholar 

  46. Steinhardt, H.J., Payer, E., Henn, B. et al. (1987). Beeinflusst die Proteinkomponente von Formuladiäten die Stickstoffabsorption beim Morbus Crohn? Z. Gastroenterol., 8, 573

    Google Scholar 

  47. Lochs, H. (1988). Infusions- und Ernährungstherapie bei entzündlichen Darmerkrankungen. In: Reissigl, H. (ed.) Handbuch der Infusionstherapie und klinischen Ernährung, Band IV, pp. 169–84

    Google Scholar 

  48. Chan, A.T.H., Fleming, C.R., O’Fallon, W.M. et al. (1986). Estimated versus measured basal energy requirement in patients with Crohn’s disease. Gastroenterology, 91, 75–8

    PubMed  CAS  Google Scholar 

  49. Matuchansky, C (1986). Parenteral nutrition in inflammatory bowel disease. Gut, 27, (S1), 81–4

    Article  PubMed  Google Scholar 

  50. Bengoa, J.M., Hanauer, S.B., Sitrin, M.D. et al. (1985). Pattern and prognosis of liver function test abnormalities during parenteral nutrition in inflammatory bowel disease. Hepatology, 5, 79–84

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. H. Lochs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Gangl
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medical Faculty of Aachen University of Technology, Aachen, Germany

    S. Matern (Director of the Third Department of Internal Medicine) (Director of the Third Department of Internal Medicine)

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Kluwer Academic Publishers

About this chapter

Cite this chapter

Lochs, H., Gangl, A. (1989). Progress in nutritional management of patients with Crohn’s disease. In: Matern, S. (eds) Clinical Research in Gastroenterology 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2488-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-2488-8_4

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-7622-7

  • Online ISBN: 978-94-009-2488-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation