Endoscopic, radiographic, and clinical response to prolonged bowel rest and home parenteral nutrition in Crohn's disease

R. F. Kushner, J. Shapir, M. D. Sitrin

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Total parenteral nutrition is widely used as a therapeutic measure in patients with severe, active Crohn's disease unresponsive to conventional medical management. We have reviewed our experience with 10 patients with nonfistulous Crohn's disease treated by home parenteral nutrition (HPN) and bowel rest (nothing-by-mouth) assessing the nutritional, radiologic, endoscopic, and clinical responses. After a mean of 4.1 months of treatment, all patients had a marked improvement in nutritional status and resolution of gastrointestinal symptoms; 90% reduced their corticosteroid dose. Eight of nine patients had endoscopic and/or radiographic evidence of mucosal healing. Although 60% of patients were able to avoid surgery and tolerate refeeding, all six patients continue to require steroids to control symptoms. Our study suggests that HPN and bowel rest is a useful therapeutic approach to selected patients with active Crohn's disease, which permits a reduction in corticosteroid dosage and partial healing of mucosal lesions in most. Further studies are required to determine which patients should receive HPN and its optimal duration.

Original languageEnglish (US)
Pages (from-to)568-573
Number of pages6
JournalJournal of Parenteral and Enteral Nutrition
Volume10
Issue number6
DOIs
StatePublished - Jan 1 1986

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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