Alterations in Nutritional Status and Disease Activity during Treatment of Crohn's Disease with Elemental Diet

Abstract

Background: The mechanisms by which elemental diets induce remission in patients with Crohn's disease is unknown, but it has been suggested that improvement in nutritional state may play a part. Methods: We assessed sequential changes in disease activity (clinical and laboratory indices and faecal excretion of-indium-111-labelled leucocytes) and nutritional status (anthropometry, body composition variables), hepatic secretory proteins (albumin, pre-albumin, transferrin), and trace elements (iron, magnesium, copper, zinc) during treatment of acute Crohn's disease with an elemental diet. Results: Disease activity indices improved significantly by 2 weeks and were maintained at 4 weeks of treatment. There was a significant increase in pre-albumin at 4 weeks and an increase in serum iron and a decrease in serum copper during the study period. The changes occurring in the measures of nutrition did not correlate significantly with the changes in disease activity. Conclusion: The fact that changes in disease activity appear to precede any detectable changes in nutritional state, it suggests that the beneficial action of elemental diet in patients with active Crohn's disease is not due to an improvement in nutritional status.

Key Words:

• Crohn's disease
• disease activity
• enteral nutrition
• inflammatory bowel disease
• intestinal inflammation