Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study
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...
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| Format: | Article |
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MDPI AG
2020-04-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/12/5/1244 |
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| author | Eran Zittan Ian M. Gralnek Ossama A. Hatoum Nasser Sakran Nitzan Kolonimos |
| author_facet | Eran Zittan Ian M. Gralnek Ossama A. Hatoum Nasser Sakran Nitzan Kolonimos |
| author_sort | Eran Zittan |
| collection | DOAJ |
| description | 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 (<i>p</i> = 0.001); BMI 19.2 vs. 19.7 kg/m<sup>2</sup> (<i>p</i> = 0.017); CRP 57.2 vs. 10.3 mg/L (<i>p</i> = 0.001); Fecal calprotectin (FC) 672 vs. 200 (μg/g); albumin 2.7 vs. 3.6 g/dL (<i>p</i> = 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. |
| first_indexed | 2024-03-10T20:11:37Z |
| format | Article |
| id | doaj.art-9bc24acc042445ab9f46e58dde8fe25e |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T20:11:37Z |
| publishDate | 2020-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-9bc24acc042445ab9f46e58dde8fe25e2023-11-19T22:54:24ZengMDPI AGNutrients2072-66432020-04-01125124410.3390/nu12051244Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot StudyEran Zittan0Ian M. Gralnek1Ossama A. Hatoum2Nasser Sakran3Nitzan Kolonimos4Ellen and Pinchas Mamber Institute of Gastroenterology and Liver Diseases and the Center for IBD, HaEmek Medical Center, Afula 1834111, IsraelEllen and Pinchas Mamber Institute of Gastroenterology and Liver Diseases and the Center for IBD, HaEmek Medical Center, Afula 1834111, IsraelRappaport Faculty of Medicine Technion-Israel Institute of Technology, Haifa 31096, IsraelRappaport Faculty of Medicine Technion-Israel Institute of Technology, Haifa 31096, IsraelEllen and Pinchas Mamber Institute of Gastroenterology and Liver Diseases and the Center for IBD, HaEmek Medical Center, Afula 1834111, IsraelBackground: 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 (<i>p</i> = 0.001); BMI 19.2 vs. 19.7 kg/m<sup>2</sup> (<i>p</i> = 0.017); CRP 57.2 vs. 10.3 mg/L (<i>p</i> = 0.001); Fecal calprotectin (FC) 672 vs. 200 (μg/g); albumin 2.7 vs. 3.6 g/dL (<i>p</i> = 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.https://www.mdpi.com/2072-6643/12/5/1244total parental nutrition (TPN)crohn’s disease (CD)clinical remissionlaboratory remission |
| spellingShingle | Eran Zittan Ian M. Gralnek Ossama A. Hatoum Nasser Sakran Nitzan Kolonimos Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study Nutrients total parental nutrition (TPN) crohn’s disease (CD) clinical remission laboratory remission |
| title | Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study |
| title_full | Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study |
| title_fullStr | Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study |
| title_full_unstemmed | Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study |
| title_short | Preoperative Exclusive Total Parental Nutrition is Associated with Clinical and Laboratory Remission in Severe Active Crohn’s Disease—A Pilot Study |
| title_sort | preoperative exclusive total parental nutrition is associated with clinical and laboratory remission in severe active crohn s disease a pilot study |
| topic | total parental nutrition (TPN) crohn’s disease (CD) clinical remission laboratory remission |
| url | https://www.mdpi.com/2072-6643/12/5/1244 |
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