ESPEN GUIDELINESESPEN Guidelines on Enteral Nutrition: Gastroenterology☆
Section snippets
What influence does CD exert on nutritional status and on energy and substrate metabolism?
1.1. Acute phase
Undernutrition with weight loss, protein deficiency and specific deficiencies in vitamins, minerals and trace elements are common in the acute phase of CD.
Anorexia, increased intestinal losses and systemic inflammation are the main causes of undernutrition.
In children and adolescents a decrease in growth velocity may occur, secondary to inadequate nutrition and steroid therapy. The relevance and extent of these deficiencies vary according to the site and extent of diseased
What influence does UC have on nutritional status as well as on energy and substrate metabolism?
Global undernutrition, as well as specific deficiencies has been described in active UC. Specific deficits including anaemia due to iron and/or folate deficiency are described even in remission. Specific deficits may also be due to drug treatment (e.g. sulphasalazine).
Comment: The information regarding undernutrition in UC derives mainly from case reports. There are no epidemiological studies that would allow estimation of the prevalence of underweight and weight loss, although weight loss is
Short-bowel syndrome (SBS)
SBS is a complex condition resulting from either loss of intestine and/or an impairment of absorptive capacity of the remaining small bowel. SBS is not defined by a certain length of the remaining bowel but rather by the loss of absorptive function. The main causes of SBS are resections after mesenteric infarctions, extensive resections in CD, trauma, and bowel damage from radiotherapy.
References (148)
- et al.
Distinguishing malnutrition from disease: the search goes on
Am J Clin Nutr
(1997) - et al.
Comprehensive nutritional status in patients with long-standing Crohn disease currently in remission
Am J Clin Nutr
(1998) - et al.
Energy metabolism and substrate oxidation in patients with Crohn's disease
Nutrition
(2000) - et al.
Effect of disease localization on the anthropometric and metabolic features of Crohn's disease
Am J Gastroenterol
(1998) - et al.
Energy and substrate metabolism in patients with active Crohn's disease
J Nutr
(1999) - et al.
The effect of disease, drug, and diet on whole body protein metabolism in adolescents with Crohn disease and growth failure
J Pediatr
(1982) - et al.
Intestinal protein loss in Crohn's disease
Gastroenterology
(1972) - et al.
Decreased height velocity in children and adolescents before the diagnosis of Crohn's disease
Gastroenterology
(1988) Nutritional management of inflammatory bowel disease
Gastroenterol Clin North Am
(1989)- et al.
Chronic intermittent elemental diet improves growth failure in children with Crohn's disease
Gastroenterology
(1988)
Body composition in patients with inflammatory bowel disease: a population-based study
Am J Gastroenterol
Multivariate identification of metabolic features in inflammatory bowel disease
Metabolism
Risk factors for low bone mineral density in children and young adults with Crohn's disease
J Pediatr
Preoperative nutritional status and other factors that influence surgical outcome in patients with Crohn's disease
Mayo Clin Proc
Home nocturnal supplemental nasogastric feedings in growth-retarded adolescents with Crohn's disease
Gastroenterology
Controlled trial of supplemented oral nutrition in Crohn's disease
Lancet
Growth failure in children with inflammatory bowel disease: a prospective study
Gastroenterology
Meta-analysis of enteral nutrition as a primary treatment of active Crohn's disease
Gastroenterology
A randomized prospective trial comparing a defined formula diet, corticosteroids, and a defined formula diet plus corticosteroids in active Crohn's disease
Mayo Clin Proc
Comparison of enteral nutrition and drug treatment in active Crohn's disease. Results of the European Cooperative Crohn's Disease Study
IV. Gastroenterology
Has total bowel rest a beneficial effect in the treatment of Crohn's disease
Clin Nutr
Oral nutritional supplementation is effective in the maintenance of remission in Crohn's disease
Dig Liver Dis
Health-related quality of life in Crohn's disease: a prospective longitudinal study in 231 patients
Am J Gastroenterol
Indications for pump-assisted enteral feeding
Lancet
Polymeric versus elemental diet as primary treatment in active Crohn's disease: a randomized, double-blind trial
Am J Gastroenterol
Impaired folic acid absorption in inflammatory bowel disease: effects of salicylazosulfapyridine (Azulfidine)
Gastroenterology
Nutritional support in inflammatory bowel disease
Dig Dis
Nutrition considerations in patients with Crohn's disease
Semin Colon Rectal Surg
Assessment of nutritional status
J Parenter Enteral Nutr
Nutrition assessment in the 1990s: where are we now?
Nutr Clin Prat
Inflammatory bowel disease: nutritional implications and treatment
Proc Nutr Soc
Nutrition in inflammatory bowel disease
An update, Scand J Gastroenterol
Nutrition in inflammatory bowel disease
Curr Opin Clin Nutr Metab Care
Total enteral nutrition support improves body composition of patients with active Crohn's disease
J Parenter Enteral Nutr
Muscle cell electrolytes in ulcerative colitis and Crohn's disease
Digestion
Evaluation of magnesium status in Crohn's disease as assessed by intracellular analysis and intravenous magnesium infusion
Scand J Gastroenterol
Nutritional deficiencies and complications in chronic inflammatory bowel diseases
Med Klin
Enteral supplementation of phosphate does not prevent hypophosphatemia during refeeding of cachectic patients
J Parenter Enteral Nutr
25-hydroxyvitamin D absorption in patients with Crohn's disease and with pancreatic insufficiency
Wien Klin Wochenschr
Low serum and bone vitamin K status in patients with longstanding Crohn's disease: another pathogenetic factor of osteoporosis in Crohn's disease?
Gut
Vitamin B12 absorption after ileorectal anastomosis for Crohn's disease: effect of ileal resection and time span after surgery
Eur J Gastroenterol Hepatol
Vitamin status in patients with inflammatory bowel disease
Am J Gastroenterol
Total energy expenditure in patients with Crohn's disease: measurement by the combined body scan technique
J Parenter Enteral Nutr
Nutritional aspects of inflammatory bowel disease
Annu Rev Nutr
Assessing nutritional state in inflammatory bowel disease
Gut
Nutritional issues in pediatric inflammatory bowel disease
J Pediatr Gastroenterol Nutr
Growth failure in pediatric inflammatory bowel disease
J Pediatr Gastroenterol Nutr
Growth and development in chronic inflammatory bowel disease
Acta Paediatr Scand
Longitudinal growth in children and adolescents with inflammatory bowel disease
J Pediatr Gastroenterol Nutr
Comprehensive nutritional status in recently diagnosed patients with inflammatory bowel disease compared with population controls
Eur J Clin Nutr
Cited by (296)
Survey of dietary beliefs and habits of inflammatory bowel disease patients
2023, Clinical Nutrition ESPENESPEN guideline on Clinical Nutrition in inflammatory bowel disease
2023, Clinical NutritionPersonalized pre-habilitation reduces anastomotic complications compared to up front surgery before ileocolic resection in high-risk patients with Crohn's disease: A single center retrospective study
2022, International Journal of SurgeryCitation Excerpt :A recent review found differences in practices or definitions between studies [29]: on the type of patients (CD phenotype, nutritional status, sepsis, etc.), on the criteria for defining undernutrition, on the administration of the nutritional support (exclusive enteral nutrition, combined nutrition (enteral and parenteral), parenteral nutrition), on the realization of a multimodal prehabilitation (antibiotic or not, discontinuation of therapies …), and over the duration of the prehabilitation (sometimes ranging from 1 week to 3 months). In IBD patients, exclusive parenteral nutrition has not been shown to be superior to enteral nutrition [30,31]. El Hussuna et al. carried out multimodal optimization to reduce postoperative complications (enteral or parenteral nutrition, antibiotic therapy, stopping corticosteroid treatments and smoking cessation) [32].
Percutaneous endoscopic gastrostomy tube replacement after head and neck surgery: A case report
2022, International Journal of Surgery Case ReportsEfficacy of nutritional support protocol for patients with pressure ulcer: comparison of before and after the protocol
2022, NutritionCitation Excerpt :According to many previous studies, providing adequate calories and protein is essential for PU healing. High-dose supplements of vitamin C and zinc are also helpful in treating chronic PU [15,17–21]. However, because most clinicians prioritize vital signs or mental status, nutritional support may be delayed or missed.
- ☆
For further information on methodology see Schütz et al.147 For further information on definition of terms see Lochs et al.148
- ☆☆
The authors of the DGEM (German Society for Nutritional Medicine) guidelines on enteral nutrition in gastroenterology are acknowledged for their contribution to this article.