Experience With Elemental Diet in the Treatment of Inflammatory Bowel Disease

Voitk, Andrus J.; Échavé, Vincent; Feller, Joseph H.; Brown, Ralph S.; Gurd, Fraser N.

doi:10.1001/archsurg.1973.01350200189039

Cited by 193 publications

(98 citation statements)

References 6 publications

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“…Although corticosteroids are more effective than enteral nutrition in inducing and sustaining remissions in patients with acute CD, enteral nutrition has been established as an inseparable part of primary treatment of active CD. 13,14 . Recently, the fat composition of enteral nutrition has been the subject of interest.…”

Section: Discussionmentioning

confidence: 99%

Lipid metabolism in active Crohn's disease: Pre-results

Hrabovský¹,

Zadák²,

Bláha³

et al. 2006

BIOMED PAP

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Background:Crohn's disease (CD) is a chronic relapsing disease. Especially acute period may be associated with metabolic disturbances. Alteration of lipid metabolism has been described in critically ill patients and hypocholesterolemia is associated with poor prognosis. The human organism acquires cholesterol by two principal processes -synthesis de novo, and absorption from the diet. It is possible to assess, using cholesterol synthesis markers (lathosterol) and cholesterol absorption markers (sitosterol, campesterol) the leading form of cholesterol acquisition.Aim: The aim of this study is assess the association between the lipid profile in plasma and the plasma concentration of sterols in active CD patients and in control subjects.Method: Routine laboratory tests, CDAI, lipid and non-cholesterol sterols plasma levels were performed on days 3, 14 and 28. The metabolic parameters have been compared with a control cohort of 100 healthy blood donors.Results: Presently, complete data for 8 patients are available The serum total cholesterol, LDL and HDL cholesterol, and triglyceride concentrations were lower in patients with acute Crohn's disease than in the control group. Moreover lathosterol, campesterol and sitosterol concentrations were lower, whereas squalene concentration was higher than in controls. As mentioned above, complete data are not currently available. Therefore statistical analysis has not been finished.Conclusion: Our pre-results show substantial abnormalities in the concentrations of plasma lipids and non-cholesterol sterols, which are presented as markers of cholesterol requirement, in patients with acute CD.

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Section: Discussionmentioning

confidence: 99%

Lipid metabolism in active Crohn's disease: Pre-results

Hrabovský¹,

Zadák²,

Bláha³

et al. 2006

BIOMED PAP

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“…This was initially postulated in adults in 1973, when a small series of patients with CD treated with an elemental diet were demonstrated to have reduced Crohn's activity, in addition to improved nutrition [Voitk et al 1973]. Since then, multiple trials and meta-analyses have attempted to assess the anti-inflammatory impact of enteral feed.…”

Section: Introductionmentioning

confidence: 99%

Nutritional management of Crohn’s disease

Donnellan

Lee

Lal

2013

Therap Adv Gastroenterol

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Nutritional care and therapy forms an integral part of the management of patients with Crohn's disease (CD). Nutritional deficiencies result from reduced oral intake, malabsorption, medication side effects and systemic inflammation due to active disease. Enteral nutrition has a role in support for the malnourished patient, as well as in primary therapy to induce and maintain remission. The use of parenteral nutrition in CD is mainly limited to the preoperative setting or for patients with intestinal failure, but does not offer any additional advantage over EN in disease control. Dietary modifications, including eliminationreintroduction diets and a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet may improve symptoms but there are currently no data to suggest that these approaches have any role in the induction or maintenance of remission.

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“…The findings of the present study suggest a crucial role for luminal environmental Ags A selective population of patients with IBD has been treated with nutritional therapy using ED (33). The ED treatment sustained remission, especially in patients with Crohn's disease (34 -36), probably by reducing digestive processes and so allowing the bowel to rest (37).…”

Section: Discussionmentioning

confidence: 64%

Alteration of Vβ Usage and Cytokine Production of CD4+ TCR ββ Homodimer T Cells by Elimination of Bacteroides vulgatus Prevents Colitis in TCR α-Chain-Deficient Mice

Kishi

Takahashi

Kai

et al. 2000

The Journal of Immunology

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A major pathogenic factor for the development of inflammatory bowel disease (IBD) is the breakdown of the intestinal homeostasis between the host immune system and the luminal microenvironment. To assess the potential influence of luminal Ags on the development of IBD, we fed TCR α−/− mice an elemental diet (ED). ED-fed TCR α−/− mice showed no pathologic features of IBD, and their aberrant mucosal B cell responses were suppressed. Similar numbers of CD4+, TCR ββ homodimer T cells (ββ T cells) were developed in the colonic mucosa of ED-fed mice; however, Th2-type cytokine productions were lower than those seen in diseased regular diet (RD)-fed mice. The higher cytokine production in diseased RD-fed mice could be attributed to the high incidence of Bacteroides vulgatus (recovered in 80% of these mice), which can induce Th2-type responses of colonic CD4+, ββ T cells. In contrast, ED-fed TCR α−/− mice exhibited a diversification of Vβ usage of ββT cell populations from the dominant Vβ8 one associated with B. vulgatus in cecal flora to Vβ6, Vβ11, and Vβ14. Rectal administration of disease-free ED-fed mice with B. vulgatus resulted in the development of Th2-type CD4+, ββ T cell-induced colitis. These findings suggest that the ED-induced alteration of intestinal microenvironments such as the enteric flora prevented the development of IBD in TCR α−/− mice via the immunologic quiescence of CD4+, ββ T cells.

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Experience With Elemental Diet in the Treatment of Inflammatory Bowel Disease

Cited by 193 publications

References 6 publications

Lipid metabolism in active Crohn's disease: Pre-results

Lipid metabolism in active Crohn's disease: Pre-results

Nutritional management of Crohn’s disease

Alteration of Vβ Usage and Cytokine Production of CD4+ TCR ββ Homodimer T Cells by Elimination of Bacteroides vulgatus Prevents Colitis in TCR α-Chain-Deficient Mice

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