TY - JOUR
T1 - Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease
AU - Ohara, Nobuyoshi
AU - Mizushima, Tsunekazu
AU - Iijima, Hideki
AU - Takahashi, Hidekazu
AU - Hiyama, Satoshi
AU - Haraguchi, Naotsugu
AU - Inoue, Takahiro
AU - Nishimura, Junichi
AU - Shinzaki, Shinichiro
AU - Hata, Taishi
AU - Matsuda, Chu
AU - Yamamoto, Hirofumi
AU - Doki, Yuichiro
AU - Mori, Masaki
N1 - Publisher Copyright:
© 2017, Springer Japan.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose: An elemental diet (ED) can suppress inflammation in patients with Crohn’s disease (CD); however, adherence to this diet is difficult. We examined the correlation between ED adherence and the postoperative recurrence of CD. Methods: The subjects of this study were 38 patients who underwent intestinal resection with anastomosis. We defined ED adherence as consuming the average daily ED dose (≥900 kcal/day) for 2 years after surgery. Patients who did not adhere to the ED were allocated to the non-ED group. We diagnosed symptomatic recurrence using the CD activity index and endoscopic recurrence using the Rutgeerts’ score. Results: The ED and non-ED groups comprised 21 and 17 patients, respectively, with ED adherence of 55.3% (21/38). At the initial endoscopy, symptomatic and endoscopic recurrence rates were 4.8 and 14.3%, respectively, in the ED group, and 23.5 and 41.2%, respectively, in the non-ED group (P = 0.152 and P = 0.078, respectively). The overall symptomatic recurrence-free duration was significantly longer than the endoscopic recurrence-free duration (P = 0.022). Symptomatic and endoscopic recurrence-free durations were longer in the ED group than in the non-ED group (P = 0.003 and P = 0.021, respectively), and ED adherence was a prognostic factor for endoscopic recurrence (HR = 2.777, 95% CI = 1.036–8.767, P = 0.042). Conclusion: Maintaining ED adherence for 2 years after surgery improved the symptomatic and endoscopic recurrence-free durations.
AB - Purpose: An elemental diet (ED) can suppress inflammation in patients with Crohn’s disease (CD); however, adherence to this diet is difficult. We examined the correlation between ED adherence and the postoperative recurrence of CD. Methods: The subjects of this study were 38 patients who underwent intestinal resection with anastomosis. We defined ED adherence as consuming the average daily ED dose (≥900 kcal/day) for 2 years after surgery. Patients who did not adhere to the ED were allocated to the non-ED group. We diagnosed symptomatic recurrence using the CD activity index and endoscopic recurrence using the Rutgeerts’ score. Results: The ED and non-ED groups comprised 21 and 17 patients, respectively, with ED adherence of 55.3% (21/38). At the initial endoscopy, symptomatic and endoscopic recurrence rates were 4.8 and 14.3%, respectively, in the ED group, and 23.5 and 41.2%, respectively, in the non-ED group (P = 0.152 and P = 0.078, respectively). The overall symptomatic recurrence-free duration was significantly longer than the endoscopic recurrence-free duration (P = 0.022). Symptomatic and endoscopic recurrence-free durations were longer in the ED group than in the non-ED group (P = 0.003 and P = 0.021, respectively), and ED adherence was a prognostic factor for endoscopic recurrence (HR = 2.777, 95% CI = 1.036–8.767, P = 0.042). Conclusion: Maintaining ED adherence for 2 years after surgery improved the symptomatic and endoscopic recurrence-free durations.
UR - http://www.scopus.com/inward/record.url?scp=85019924438&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019924438&partnerID=8YFLogxK
U2 - 10.1007/s00595-017-1543-5
DO - 10.1007/s00595-017-1543-5
M3 - Article
C2 - 28534264
AN - SCOPUS:85019924438
VL - 47
SP - 1519
EP - 1525
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 12
ER -