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Evidence summaries

Enteral Nutrition for Maintenance of Remission in Crohn's Disease

Enteral nutritional supplementation using elemental or polymeric formulas may be effective for maintenance of remission in Crohn's disease. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 2 studies with a total of 84 subjects. In one study, patients who received half of their total daily calorie requirements as elemental diet and the remaining half by normal diet had a significantly lower relapse rate compared to patients who received unrestricted normal diet (9 of 26 versus 16 of 25; OR 0.3, 95% CI 0.09 to 0.94). In the other study, elemental and polymeric feeds (providing between 35 and 50% of patients' pretrial calorie intake in addition to unrestricted normal food) were equally effective for maintenance of remission and allowing withdrawal of steroid therapy (8 of 19 versus 6 of 14; OR 0.97, 95% CI 0.24 to 3.92).

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (few patients and wide confidence intervals).

References

  • Akobeng AK, Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007 Jul 18;(3):CD005984. [PubMed]

Primary/Secondary Keywords