Long-chain triglycerides reduce the efficacy ofenteral feeds in patients with active Crohn's disease

Middleton, Stephen; Rucker, Justin; Kirby, G. A.; Riordan, A. M.; Hunter, John

doi:10.1016/s0261-5614(95)80004-2

Cited by 102 publications

(64 citation statements)

References 19 publications

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“…Also, a polymeric enteral diet containing high amounts of MCT is as effective as a very low fat elemental diet in inducing remission in active CD [90]. In fact, when the composition of the diets reported as highly effective in inducing remission in active CD are carefully analyzed, it can be observed that those with a higher remission rate are those with very low fat content and those where one third of the fat source was MCT [73,91].…”

Section: Is Diet a Factor In The Etiopathogenesis Of Ibd? Does It Expmentioning

confidence: 99%

Nutrition and Inflammatory Bowel Disease: Its Relation to Pathophysiology, Outcome and Therapy

Gassull

2003

Dig Dis

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Nutritional deficiencies are frequent in patients with ulcerative colitis and Crohn’s disease, and negatively influence the outcome of the disease. Growth retardation, osteopenia and thromboembolic phenomena are some of the inflammatory bowel disease complications in which nutritional deficits are involved. Moreover, nutrients can play a role in the pathogenesis of the disease and, in some cases, can be a primary therapeutic tool. Enteral nutrition has proven to play a therapeutic role in Crohn’s disease. The nutrient(s) responsible for this effect are not well identified but dietary fat appears to be a major factor. In ulcerative colitis, unabsorbable carbohydrates can modulate the intestinal microbial environment, thus contributing to improve colonic inflammation.

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Section: Is Diet a Factor In The Etiopathogenesis Of Ibd? Does It Expmentioning

confidence: 99%

Nutrition and Inflammatory Bowel Disease: Its Relation to Pathophysiology, Outcome and Therapy

Gassull

2003

Dig Dis

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“…Some, but not all, studies have reported that EDs were more effective than polymeric diets for inducing clinical remission (29-33). Some studies have reported a dietary fat comparison where a high amount of dietary fat in the ED formula decreased its therapeutic effect (34,35), and it was also reported that the remission rate was negatively correlated with the amount of long-chain triglycerides of elemental or polymeric diets by meta-analysis (36).…”

Section: Discussionmentioning

confidence: 98%

An Elemental Diet Controls Inflammation in Indomethacin-Induced Small Bowel Disease in Rats: The Role of Low Dietary Fat and the Elimination of Dietary Proteins

et al. 2005

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Elemental diets (EDs) are effective in treating Crohn's disease. We hypothesize that low dietary fat and amino acids used as the sole nitrogen source are the major contributors for the success of EDs. We examined the influences of the addition of dietary fat and protein to an ED using an indomethacin-induced inflammation model in rat small intestine. In the ED-fed rats, the intestinal damage score was decreased compared with that in the standard chow group with decreasing intestinal permeability. By supplementing an ED with soybean oil (SO), intestinal permeability was increased to a level similar to that of the standard chow group. For this group, the intestinal damage score also increased compared with that of the ED group but did not reach the levels observed in the standard chow group. The addition of dietary proteins (using heat-denatured pancreatin) resulted in intestinal damage scores that were significantly higher than those of the ED+SO-fed group. The dietary protein increased the intestinal damage score. These results suggest that EDs control inflammation by decreasing intestinal permeability and the elimination of dietary proteins.

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“…A negative correlation be-tween remission rates and long-chain triglyceride intake was observed in a meta-analysis of 15 randomized controlled series 61 . EN efficacy is also limited by disease location, once ileal disease has a faster and more complete response to treatment when compared to more diffuse disease or colonic or perianal disease 15,33 .…”

Section: Enteral Nutrition (En)mentioning

confidence: 99%

Inflammatory bowel diseases: principles of nutritional therapy

et al. 2002

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Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory response, thus influencing disease activity. Total parenteral nutrition has been used to correct and to prevent nutritional disturbances and to promote bowel rest during active disease, mainly in cases of digestive fistulae with high output. Its use should be reserved for patients who cannot tolerate enteral nutrition. Enteral nutrition is effective in inducing clinical remission in adults and promoting growth in children. Due to its low complication rate and lower costs, enteral nutrition should be preferred over total parenteral nutrition whenever possible. Both present equal effectiveness in primary therapy for remission of active Crohn's disease. Nutritional intervention may improve outcome in certain individuals; however, because of the costs and complications of such therapy, careful selection is warranted, especially in patients presumed to need total parenteral nutrition. Recent research has focused on the use of nutrients as primary treatment agents. Immunonutrition is an important therapeutic alternative in the management of inflammatory bowel diseases, modulating the inflammation and changing the eicosanoid synthesis profile. However, beneficial reported effects have yet to be translated into the clinical practice. The real efficacy of these and other nutrients (glutamine, short-chain fatty acids, antioxidants) still need further evaluation through prospective and randomized trials.

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Long-chain triglycerides reduce the efficacy ofenteral feeds in patients with active Crohn's disease

Cited by 102 publications

References 19 publications

Nutrition and Inflammatory Bowel Disease: Its Relation to Pathophysiology, Outcome and Therapy

Nutrition and Inflammatory Bowel Disease: Its Relation to Pathophysiology, Outcome and Therapy

An Elemental Diet Controls Inflammation in Indomethacin-Induced Small Bowel Disease in Rats: The Role of Low Dietary Fat and the Elimination of Dietary Proteins

Inflammatory bowel diseases: principles of nutritional therapy

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