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 - Funding Information:
This work was supported in part by Osaka Medical Research Foundation for Intractable Disease and Health and Labour Sciences Research Grants for research on intractable diseases from the Ministry of Health, Labour and Welfare of Japan.
Publisher Copyright:
© 2017, Springer Japan.
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.
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U2 - 10.1007/s00595-017-1543-5
DO - 10.1007/s00595-017-1543-5
M3 - Article
C2 - 28534264
AN - SCOPUS:85019924438
SN - 0941-1291
VL - 47
SP - 1519
EP - 1525
JO - Surgery Today
JF - Surgery Today
IS - 12
ER -