Park Yong Eun, Park Yehyun, Park Soo Jung, Kim Tae Il, Kim Won Ho, Kim Jung Nam, Lee Na Rae, Cheon Jae Hee
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Division of Gastroenterology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea.
Intest Res. 2020 Jan;18(1):85-95. doi: 10.5217/ir.2019.00055. Epub 2019 Jul 19.
BACKGROUND/AIMS: Patients with inflammatory bowel disease (IBD) are usually hospitalized because of aggravated gastrointestinal symptoms. Many clinicians empirically advise these patients to fast once they are admitted. However, there has been no evidence that maintaining a complete bowel rest improves the disease course. Therefore, we aimed to investigate the effects of fasting on disease course in admitted patients with IBD or intestinal Behçet's disease.
A total of 222 patients with IBD or intestinal Behçet's disease, who were admitted for disease-related symptoms, were retrospectively analyzed. We divided them into 2 groups: fasting group (allowed to take sips of water but no food at the time of admission) and dietary group (received liquid, soft, or general diet).
On admission, 124 patients (55.9%) started fasting and 98 patients (44.1%) started diet immediately. Among patients hospitalized through the emergency room, a significantly higher proportion underwent fasting (63.7% vs. 21.4%, P<0.001); however, 96.0% of the patients experienced dietary changes. Corticosteroid use (P<0.001; hazard ratio, 2.445; 95% confidence interval, 1.506-3.969) was significantly associated with a reduction in the disease activity score, although there was no significant difference between the fasting group and the dietary group in disease activity reduction (P=0.111) on multivariate analysis.
In terms of disease activity reduction, there was no significant difference between the fasting and dietary groups in admitted patients with IBD, suggesting that imprudent fasting is not helpful in improving the disease course. Therefore, peroral diet should not be avoided unless not tolerated by the patient.
背景/目的：炎症性肠病（IBD）患者常因胃肠道症状加重而住院。许多临床医生经验性地建议这些患者入院后禁食。然而，尚无证据表明完全肠道休息能改善病程。因此，我们旨在研究禁食对IBD或肠道白塞病入院患者病程的影响。
回顾性分析222例因疾病相关症状入院的IBD或肠道白塞病患者。我们将他们分为两组：禁食组（入院时允许少量饮水但禁食）和饮食组（接受流食、软食或普通饮食）。
入院时，124例患者（55.9%）开始禁食，98例患者（44.1%）立即开始饮食。在通过急诊室入院的患者中，禁食的比例显著更高（63.7%对21.4%，P<0.001）；然而，96.0%的患者经历了饮食变化。使用皮质类固醇（P<0.001；风险比，2.445；95%置信区间，1.506 - 3.969）与疾病活动评分降低显著相关，尽管在多变量分析中禁食组和饮食组在疾病活动度降低方面无显著差异（P = 0.111）。
在降低疾病活动度方面，IBD入院患者的禁食组和饮食组之间无显著差异，这表明盲目禁食无助于改善病程。因此，除非患者不耐受，否则不应避免经口饮食。
