Nutrición enteral en crisis grave de colitis ulcerosa: efectividad nutricional y tolerancia digestiva / Enteral nutrition in severe ulcerative colitis: safety, tolerance and nutritional efficiency

RESUMO

Backgrounds and aims: Total parenteral nutrition (TPN) has been traditionally used as an adjunctive therapy in severe ulcerative colitis patients. We performed a prospective study to ascertain the safety, nutritional efficiency, tolerance and costs of total enteral nutrition in this situation. Methods: After 48 hours of intensive medical treatment, severe ulcerative colitis patients initiated enteral feeding with a polymeric formula. The formula concentration and volume were increased daily. Results: 17 patients (7 women, 10 men; age 36,8ñ12,8 years) with a mean clinical activity score of 15,6ñ1,5 were included. In 14 patients (82,4percent) enteral nutrition was well tolerated, attaining in 11 of them more than 80percent of the caloric requirements by day 4. In 3 cases we observed vomiting and bloating. Prealbumin levels improved significantly from 11,1ñ3,4 mg/dl to 22,7ñ6,8 mg/dl (p= 0.002) at the end of enteral nutrition (11,8ñ4,7 days). Albumin and other nutritional parameters did not change. Conclusions: Total enteral nutrition could be considered a safe and well tolerated nutritional support in these patients. Although albumin and other nutritional parameters did not change during the study period, the increase in prealbumin levels suggests a favourable anabolic effect of total enteral nutrition