Implementation and effect of home enteral nutrition in outpatients with Crohn's disease / 中华临床营养杂志

ABSTRACT

Objective To guide the implementation of home enteral nutrition (EN) for outpatients with Crohn's disease, and to observe its effect.Methods In this observational study, 26 patients at active period of Crohn's disease were collected between April 2014 and June 2015 in the clinic of Clinical Nutrition Center of Nanjing General Hospital of Nanjing Military Command.Home EN combined with medication was administered.The nutritional status, Crohn's Disease Activity Index (CDAI), and quality of life before and after EN were compared.Results After home EN therapy, body mass index (BMI) of the patients increased from (17.7 ± 2.1) kg/m2 to (19.8 ± 2.0) kg/m2 (P ＜ 0.001), proportion of lymphocytes from (0.216 ± 0.066) to (0.305 ± 0.106) (P =0.007), albumin level from (40.3 ± 5.9) g/L to (43.7 ± 5.4) g/L (P =0.038), prealbumin from (233.1 ± 71.5) mg/L to (306.0 ± 72.1) mg/L (P =0.009), and transferrin from (2.7 ± 0.6) g/L to (3.1 ±0.7) g/L (P =0.038).In the indicators reflecting the activity of Crohn's disease, CDAI declined from 197.0 ±55.8 to 113.2 ±33.4 (P ＜0.001) after EN, C-reactive protein from 28.50 (18.00-32.80) mg/L to 2.00 (0.58-6.33) mg/L (P ＜0.001), erythrocyte sedimentation rate from (29.6 ± 9.9) mm/h to (9.4 ± 7.6) mm/h (P ＜ 0.001).The patient's disease activity scores and inflammatory reaction indexes all reached the normal levels after EN, show that the patients were in remission stage.In inflammatory bowel disease quality of life score, the score of intestinal symptoms rose from 41.2 ± 13.3 to 57.0 ±9.6 (P ＜ 0.001), the score of systemic symptom from 20.7 ± 5.5 to 28.9 ± 4.2 (P ＜ 0.001), emotional ability from 43.6±16.1 to 61.0 ± 15.9 (P=0.002), and social ability from 20.6 ±4.9 to 28.4 ±5.6 (P＜0.001), all showing statistical significance.Conclusions Standardized home enteral nutrition in patients at active period of Crohn's disease, when implemented under professional guidance of nutritional support team and well followed up, may improve nutritional status, induce remission, and improved quality of life.