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Factors Affecting Recurrence in Patients with Crohn’s Disease Under Nutritional Therapy

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Diseases of the Colon & Rectum

Purpose

This retrospective study was designed to determine risk factors for recurrence of Crohn’s disease under enteral nutrition.

Methods

The clinical course of 145 patients with Crohn’s disease, who were primarily induced into remission by total parenteral nutrition, was reviewed. The patients were classified into two groups: enteral nutrition group (n = 98; ≥1,200 kcal/day of enteral nutrition), or nonenteral nutrition group (n = 47;<1,200 kcal/day of enteral nutrition) according to the amount of their daily elemental or polymeric diet. Contributions of enteral nutrition and other clinical variables to the recurrence were analyzed retrospectively. A Crohn’s disease activity index of >150 plus an increase in Crohn’s disease activity index of >70 from the baseline value was defined as recurrence.

Results

Forty-two patients in the enteral nutrition group and 29 patients in the nonenteral nutrition group recurred during periods ranging from 3 to 159 months. The cumulative rate of recurrence was significantly higher in the nonenteral nutrition group than in the enteral nutrition group (P = 0.047). Among the Crohn’s disease patients in the enteral nutrition group, penetrating type (relative risk, 3.89; 95 percent confidence interval, 1.58–9.62), colonic involvement (relative risk, 3.10; 95 percent confidence interval, 1.39–6.9), and previous history of surgery (relative risk, 2.48; 95 percent confidence interval, 1.16–5.33) were factors that significantly affected recurrence. In contrast, penetrating type was the only possible factor associated with recurrence in the nonenteral nutrition group (relative risk, 2.75; 95 percent confidence interval, 0.96–7.81).

Conclusions

Among patients with Crohn’s disease under maintenance enteral nutrition, the risk of recurrence differs according to the disease type and the site of involvement. The maintenance treatment by enteral nutrition alone seems insufficient for patients with penetrating type or with colonic involvement.

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi, Higashi-ku, Fukuoka, Japan

    Motohiro Esaki M.D., Takayuki Matsumoto M.D., Shotaro Nakamura M.D., Shinichiro Yada M.D., Kiyoshi Fujisawa M.D., Yukihiko Jo M.D. & Mitsuo Iida M.D.

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  1. Motohiro Esaki M.D.
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  2. Takayuki Matsumoto M.D.
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  3. Shotaro Nakamura M.D.
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  4. Shinichiro Yada M.D.
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  5. Kiyoshi Fujisawa M.D.
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  6. Yukihiko Jo M.D.
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  7. Mitsuo Iida M.D.
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Correspondence to Motohiro Esaki M.D..

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Esaki, M., Matsumoto, T., Nakamura, S. et al. Factors Affecting Recurrence in Patients with Crohn’s Disease Under Nutritional Therapy. Dis Colon Rectum 49 (Suppl 1), S68–S74 (2006). https://doi.org/10.1007/s10350-006-0692-1

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  • DOI: https://doi.org/10.1007/s10350-006-0692-1

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