Nutritional support in Crohn's disease: which route?

Nutritional and clinical responses to three nutritional regimens were retrospectively evaluated in 81 Crohn's patients with active disease. Group 1 (n = 42) received a low residue oral diet, group 2 (n = 15) received chemically defined diets, and group 3 (n = 24), parenteral nutrition (PN). Weight gain was observed in a similar percentage of patients, whereas serum albumin increase was significant only in group 3: 3.15 +/- 0.66 versus 3.54 +/- 0.61 g/100 ml (p less than 0.05). Mean activity index decreased significantly in all groups (p less than 0.001), and length of stay in hospital was similar. Patients with intestinal obstruction had a better immediate response when submitted to PN: clinical remission was achieved in 75% of those in group 3, but in only 50% in groups 1 and 2 (p less than 0.05). Otherwise, short- and long-term outcome was similar.