Infliximab Combined with Enteral Nutrition for Managing Crohn’s Disease Complicated with Intestinal Fistulas

Abstract

Aim. This study was performed to evaluate the additional enteral nutrition (EN) in the efficacy of infliximab (IFX) compared with the conventional therapy in managing Crohn's disease (CD) complicated with intestinal fistulas. Methods. A total of 42 CD with intestinal fistulas were randomly divided into infliximab treatment group (n = 20) and conventional therapy group (n = 22). We evaluated the laboratory indexes, Crohn's disease activity index (CDAI), Crohn's disease simplified endoscopic score (SES-CD), and healing of fistula in the two groups before treatment, at 14 weeks, and at 30 weeks, respectively. Results. In the IFX treatment group, the CDAI score, the SES-CD, erythrocyte sedimentation rate, and C-reactive protein levels were significantly decreased during treatment compared with those before treatment. The body mass index and albumin levels were increased in both groups. Moreover, in the IFX treatment group, fistula healing was found in 8 at the 14th week and 18 at the 30th week, respectively, which was greater than that in the conventional therapy group. Conclusion. Our study suggested that infliximab combined with EN is an effective treatment for CD patients complicated with intestinal fistulas.

Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease

“…Enteral nutrition has also been used as an adjunct to infliximab in fistulizing CD. Wu et al [ 31 ] found that infliximab in combination with EEN was more effective in management of fistulizing CD when compared with infliximab alone. In the present study, of the 9 patients with fistulizing CD, although none could achieve clinical remission (CDAI < 150), clinical response rates to EEN were 100%.…”

Network meta-analysis: efficacy and safety of treatments for fistulising Crohn’s disease

“…Three further studies were excluded as their endpoints were in a form that could not be compared to the other sides. Maeda et al [9] reported an improvement in pediatric crohn's disease activity index score, Sandborn et al [10] reported an improvement in crohn's disease activity index score and Wu et al [11] reported an improvement in simple endoscopic score for crohn's disease score. The characteristics of the included 25 studies are displayed in Table 1.…”

Ileo-ileal fistula with severe malnutrition caused by strangulated ileus surgery while preserving ischemic ileum: A case report

“…They are typically diagnosed in a delayed manner due to a lack of specific and obvious symptoms. Most reports of entero-enteric fistulae were caused by Crohn’s disease [ 4 , 8 , 9 ]. In several other cases, including duodenal ulcer, intestinal tuberculosis, Henoch-Schönlein purpura and necrotizing enteritis in children, iatrogenic and magnetic foreign body ingestion have been reported [ 4 , [10] , [11] , [12] , [13] ].…”