Effects of exclusive enteral nutrition on the mucosal healing in adult patients with active Crohn's disease / 中华消化杂志

ABSTRACT

Objective To explore the effects of exclusive enteral nutrition (EEN) on the mucosal healing under endoscopy in adults with active Crohn's disease (CD).Methods From August 2011 to August 2012,adults with active CD met the inclusion criteria were prospectively enrolled and treated with EEN for four weeks.CD activity index(CDAI) score,C-reactive protein (CRP) were evaluated once enrolled and by the end of the second and fourth week.Colonoscopy or small intestinal endoscopy examination was conducted once enrolled and by the end of fourth week,and CD simplified endoscopic score (SES-CD) was also caculated.Wilcoxon test was applied to compare the efficacy.Results Eight patients met inclusion criteria and finished the study.Seven cases achieved clinical remission.Compared with those before treatment,both CDAI score and CRP level decreased significantly after treatment (both Z=2.52,both P=0.012).After treatment,two patients achieved mucosal healing and the mucosa of six cases improved.The mucosa healing rate and improvement rate of terminal ileum was higher than that of colon (3/8 vs 1/6; 5/8 vs 3/6).Compared with those before treatment,SES-CD total score and SES-CD score of ileum decreased significantly after treatment (Z=2.23,2.07; P=0.026,0.038).There was no significant difference in SES-CD score of colon before and after treatment (P =0.102).Conclusions EEN could induce clinical remission in adults with active CD,and promote the healing of mucosal ulcer under endoscopy.The healing rate of colon was lower than that of small intestine.