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Clinical nutrition, enteral and parenteral nutrition

Predictors of response to enteral nutrition in abdominal enterocutaneous fistula patients with Crohn's disease

European Journal of Clinical Nutrition volume 68, pages 959–963 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

Enterocutaneous fistula (ECF) is a serious complication of Crohn’s disease (CD). Enteral nutrition (EN) is believed as one of therapeutic strategies of CD. This study is dedicated to identify predictors of response to EN in CD, which may lead to a better selection of fistula patients for this therapy.

Subjects/Methods:

Forty-eight CD patients with ECF treated with short-peptide-based EN for 3 months were included in this study. All patients were followed up for at least 6 months. Logistic regression was performed to investigate the potential predictors of response to EN in these patients.

Results:

In total, 30 out of 48 patients were confirmed with a successful closure of fistula after 3 months’ EN therapy. The average closure time was 32.4±8.85 days. Inflammatory parameters (erythrocyte sedimentation rate, C-reactive protein (CRP) and platelet count) improved significantly after EN therapy in all enrolled patients. Specifically, the improvement of CRP after therapy in closed group was more important compared with that in unclosed group (P=0.035). Nutrition status (body weight, body mass index (BMI), hemoglobin, serum albumin (ALB), serum prealbumin and total protein (TP)) improved as well (P<0.05). Similarly, after treatment, the improvement of serum albumin (P=0.046) and prealbumin (P=0.006) in closed group was much more important than those in unclosed group. Logistic regression analysis discovered that a decreased CRP level and an elevated BMI level would be beneficial to the response to EN in CD patients with ECF.

Conclusions:

In CD patients with ECF, lower CRP and higher BMI are associated with higher possibility of closure after EN treatment. EN therapy can lead to a closure of ECF in a certain proportion of patients. EN therapy could also ameliorate inflammatory condition and improve nutrition status.

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Acknowledgements

This work was supported by grants from Advanced Training Program for Research Talents of Jiangsu Province, China (BRA2011232) and National Science Foundation of China (81270478).

DISCLAIMER

The study design and procedures were approved by the Institutional Review Board (IRB) Ethics Committee at Jinling Hospital.

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Authors and Affiliations

  1. Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China

    D Yan, J Ren, G Wang, S Liu & J Li

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  1. D Yan
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Correspondence to J Ren.

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Yan, D., Ren, J., Wang, G. et al. Predictors of response to enteral nutrition in abdominal enterocutaneous fistula patients with Crohn's disease. Eur J Clin Nutr 68, 959–963 (2014). https://doi.org/10.1038/ejcn.2014.31

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