ALTERATIONS IN NUTRITIONAL-STATUS AND DISEASE-ACTIVITY DURING TREATMENT OF CROHNS-DISEASE WITH ELEMENTAL DIET

Background: The mechanisms by which elemental diets induce remission i n patients with Crohn's disease is unknown, but it has been suggested that improvement in nutritional state may play a part. Methods: We ass essed sequential changes in disease activity (clinical and laboratory indices and faecal excretion of indium-111-labelled leucocytes) and nu tritional status (anthropometry, body composition variables), hepatic secretory proteins (albumin, pre-albumin, transferrin), and trace elem ents (iron, magnesium, copper, zinc) during treatment of acute Crohn's disease with an elemental diet. Results: Disease activity indices imp roved significantly by 2 weeks and were maintained at 4 weeks of treat ment. There was a significant increase in pre-albumin at 4 weeks and a n increase in serum icon and a decrease in serum copper during the stu dy period. The changes occurring in the measures of nutrition did not correlate significantly with the changes in disease activity. Conclusi on: The fact that changes in disease activity appear to precede any de tectable changes in nutritional state, it suggests that the beneficial action of elemental diet in patients with active Crohn's disease is n ot due to an improvement in nutritional status.