Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease

Nobuyoshi Ohara, Tsunekazu Mizushima, Hideki Iijima, Hidekazu Takahashi, Satoshi Hiyama, Naotsugu Haraguchi, Takahiro Inoue, Junichi Nishimura, Shinichiro Shinzaki, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1519-1525
Number of pages7
JournalSurgery Today
Volume47
Issue number12
DOIs
Publication statusPublished - Dec 1 2017
Externally publishedYes

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Formulated Food
Crohn Disease
Recurrence
Diet
Endoscopy

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Ohara, N., Mizushima, T., Iijima, H., Takahashi, H., Hiyama, S., Haraguchi, N., ... Mori, M. (2017). Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease. Surgery Today, 47(12), 1519-1525. https://doi.org/10.1007/s00595-017-1543-5

Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease. / Ohara, Nobuyoshi; Mizushima, Tsunekazu; Iijima, Hideki; Takahashi, Hidekazu; Hiyama, Satoshi; Haraguchi, Naotsugu; Inoue, Takahiro; Nishimura, Junichi; Shinzaki, Shinichiro; Hata, Taishi; Matsuda, Chu; Yamamoto, Hirofumi; Doki, Yuichiro; Mori, Masaki.

In: Surgery Today, Vol. 47, No. 12, 01.12.2017, p. 1519-1525.

Research output: Contribution to journalArticle

Ohara, N, Mizushima, T, Iijima, H, Takahashi, H, Hiyama, S, Haraguchi, N, Inoue, T, Nishimura, J, Shinzaki, S, Hata, T, Matsuda, C, Yamamoto, H, Doki, Y & Mori, M 2017, 'Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease', Surgery Today, vol. 47, no. 12, pp. 1519-1525. https://doi.org/10.1007/s00595-017-1543-5
Ohara N, Mizushima T, Iijima H, Takahashi H, Hiyama S, Haraguchi N et al. Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease. Surgery Today. 2017 Dec 1;47(12):1519-1525. https://doi.org/10.1007/s00595-017-1543-5
Ohara, Nobuyoshi ; Mizushima, Tsunekazu ; Iijima, Hideki ; Takahashi, Hidekazu ; Hiyama, Satoshi ; Haraguchi, Naotsugu ; Inoue, Takahiro ; Nishimura, Junichi ; Shinzaki, Shinichiro ; Hata, Taishi ; Matsuda, Chu ; Yamamoto, Hirofumi ; Doki, Yuichiro ; Mori, Masaki. / Adherence to an elemental diet for preventing postoperative recurrence of Crohn’s disease. In: Surgery Today. 2017 ; Vol. 47, No. 12. pp. 1519-1525.
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abstract = "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.",
author = "Nobuyoshi Ohara and Tsunekazu Mizushima and Hideki Iijima and Hidekazu Takahashi and Satoshi Hiyama and Naotsugu Haraguchi and Takahiro Inoue and Junichi Nishimura and Shinichiro Shinzaki and Taishi Hata and Chu Matsuda and Hirofumi Yamamoto and Yuichiro Doki and Masaki Mori",
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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

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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