Preoperative exclusive total parental nutrition is associated with clinical and laboratory remission in severe active crohn’s disease—a pilot study

Eran Zittan, Ian M. Gralnek, Ossama A. Hatoum, Nasser Sakran, Nitzan Kolonimos

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: The effect of 1–3 months of preoperative exclusive total parental nutrition (TPN) in active Crohn’s disease (CD) patients is not well established. We investigated the efficacy of exclusive TPN in active CD patients. Methods: In a retrospective multi-visit study with data according to our standard care therapy, we assessed clinical and laboratory remission to refractory CD with exclusive preoperative TPN. Inclusion required exclusive preoperative home TPN without additional oral intake for 1–3 months prior to planning surgery. Results: Twenty preoperative CD patients (65% male; 35% female) were on exclusive TPN. The mean age of the cohort was 30.8 ± 11.6 years. Mean duration of preoperative TPN treatment was 73 days (range: 24–142 days). Most patients had terminal ileal (35%) or ileocolonic CD (30%), and with stricturing (B2) phenotype. All 20 patients had significant clinical improvement in all disease activity indices at the end of preoperative TPN (baseline vs. post TPN): HBI 14.5 vs. 4.0 (p = 0.001); BMI 19.2 vs. 19.7 kg/m2 (p = 0.017); CRP 57.2 vs. 10.3 mg/L (p = 0.001); Fecal calprotectin (FC) 672 vs. 200 (µg/g); albumin 2.7 vs. 3.6 g/dL (p = 0.001). Two patients (10%) no longer required surgery after completion of exclusive TPN. Conclusion: Exclusive preoperative TPN was found to provide significant improvement in nutritional status, and clinical and laboratory remission in severe active Crohn’s patients.

Original languageEnglish
Article number1244
JournalNutrients
Volume12
Issue number5
DOIs
StatePublished - 28 Apr 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Ellen and Pinchas Mamber Institute of Gastroenterology and Liver Diseases and the Center for IBD, HaEmek Medical Center, Afula, Israel.

FundersFunder number
HaEmek Medical Center, Afula, Israel
Pinchas Mamber Institute of Gastroenterology and Liver Diseases

    Keywords

    • Clinical remission
    • Crohn’s disease (CD)
    • Laboratory remission
    • Total parental nutrition (TPN)

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