Triantafillidis John K, Vagianos Costas, Papalois Apostolos E
Inflammatory Bowel Disease Unit, IASO General Hospital, 264 Mesogeion Avenue, Holargos, 15562 Athens, Greece.
1st Surgical Unit, Saint Panteleimon Hospital, D. Mantouvalou 3, 18454 Nicea, Greece.
Biomed Res Int. 2015;2015:197167. doi: 10.1155/2015/197167. Epub 2015 Feb 22.
Enteral nutrition (EN) is considered to be of great importance in patients with inflammatory bowel disease (IBD) and nutritional problems. This comprehensive review is aiming to provide the reader with an update on the role of EN in IBD patients. EN can reduce Crohn's disease (CD) activity and maintain remission in both adults and children. Nutritional support using liquid formulas should be considered for CD patients and in serious cases of ulcerative colitis (UC), especially for those who may require prolonged cycles of corticosteroids. Given that the ultimate goal in the treatment of CD is mucosal healing, this advantage of EN over corticosteroid treatment is valuable in therapeutic decision-making. EN is indicated in active CD, in cases of steroid intolerance, in patient's refusal of steroids, in combination with steroids in undernourished individuals, and in patients with an inflammatory stenosis of the small intestine. No differences between the efficiency of elemental diets and nonelemental formulas have been noticed. EN must be the first choice compared to TPN. EN has a restricted value in the treatment of patients with large bowel CD. In conclusion, it seems important not to underestimate the role of nutrition as supportive care in patients with IBD.
肠内营养(EN)在炎症性肠病(IBD)和存在营养问题的患者中被认为非常重要。这篇综述旨在为读者提供EN在IBD患者中作用的最新信息。EN可以降低克罗恩病(CD)的活动度,并在成人和儿童中维持缓解状态。对于CD患者以及严重的溃疡性结肠炎(UC)病例,尤其是那些可能需要长期使用皮质类固醇的患者,应考虑使用液体配方进行营养支持。鉴于CD治疗的最终目标是黏膜愈合,EN相对于皮质类固醇治疗的这一优势在治疗决策中很有价值。EN适用于活动期CD、存在类固醇不耐受的情况、患者拒绝使用类固醇、与类固醇联合用于营养不良的个体以及患有小肠炎性狭窄的患者。未发现要素饮食和非要素配方的效果存在差异。与肠外营养(TPN)相比,EN必须是首选。EN在大肠CD患者的治疗中价值有限。总之,似乎重要的是不要低估营养作为IBD患者支持性护理的作用。