Assessment of the Therapeutic Value of an Elemental Diet in Chronic Inflammatory Bowel Disease

Publisher Website
Google Scholar
Abstract
Patients (34) with chronic inflammatory bowel disease, 23 with ulcerative colitis and 11 with Crohn''s disease, were treated with elemental diet. Thirty-one patients were on high dose prednisone therapy 1-4 wk prior to the diet with no or insufficient response. Fifteen patients (44%) went into remission when elemental diet was introduced as the only change of treatment. Six patients (18%) went into remission when the dietary treatment was supplemented with high dose prednisone treatment (2 cases) or an increase of prednisone dose (4 cases). Remission occurred in 16 of 21 patients with disease of moderate activity, but in only 5 of 13 cases with severe disease. Remission rate was higher in patients with a limited extent of the lesion, but 8 patients with extensive colitis responded to treatment. There was no significant change of Hb, serum Fe, transferrin, albumin, orosomucoid or renal excretion of creatinine. Significant decreases were observed of sedimentation rate, renal urea excretion, fecal volume and daily number of bowel movements. Colectomy was performed in 8 patients whose condition remained unchanged or aggravated during treatment. Follow-up studies of non-operated patients who went into remission showed that 6 of 13 patients with ulcerative colitis were perfectly well 7-28 mo. after the study, 3 patients suffered a mild recurrence after 4-24 mo., and 4 patients were colectomized 5-10 mo. later due to severe attack. Of 8 patients with Crohn''s disease 4 remained unoperated and free of symptoms 22-35 mo. after the study.