Treatment of Crohn's disease with home parenteral nutrition. 1977

R M Rault, and B H Scribner

Home parenteral nutrition was used to treat 9 patients with severe Crohn's enterocolitis. Seven patients had a short bowel syndrome after multiple resections of bowel. In 2 patients home parenteral nutrition was used as primary therapy. The treatment was well tolerated and proved successful in 8 of 9 patients. Three patients have been able to discontinue parenteral infusions and currently are in remission. The main complications were associated with the access device which was replaced in 3 patients. Five patients currently have abnormal liver function tests without progressive liver disease. It is concluded that home parenteral nutrition is an important new therapeutic modality which can reduce or even eliminate the need for repeated or prolonged hospitalization of patients with short bowel syndrome complicating severe Crohn's disease. In addition, the technique of home parenteral nutrition, because it is relatively simple and safe, lends itself to early intervention in severe fulminant cases of Crohn's disease. This approach can result in healing of fistulae and abscesses and greatly shortening the period of hospitalization. The patient is more rapidly rehabilitated, and his fear of early relapse and recurrent malnutrition is minimized, thus facilitating a prolonged period of bowel rest which can lead to eventual remission. Home parenteral nutrition should be kept in mind as a possible alternative to early surgical intervention in selected cases of severe Crohn's disease.

UI MeSH Term Description Entries
D008722 Methods A series of steps taken in order to conduct research. Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D003424 Crohn Disease A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients. Colitis, Granulomatous,Enteritis, Granulomatous,Enteritis, Regional,Ileitis, Regional,Ileitis, Terminal,Ileocolitis,Crohn's Disease,Crohn's Enteritis,Inflammatory Bowel Disease 1,Regional Enteritis,Crohns Disease,Granulomatous Colitis,Granulomatous Enteritis,Regional Ileitides,Regional Ileitis,Terminal Ileitis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012646 Self Administration Administration of a drug or chemical by the individual under the direction of a physician. It includes administration clinically or experimentally, by human or animal. Administration, Self,Administrations, Self,Self Administrations

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