ENTERAL NUTRITION IN SEVERE ULCERATIVE-COLITIS - SAFETY, TOLERANCE AND NUTRITIONAL EFFICIENCY

Backgrounds and aims: Total parenteral nutrition (TPN) has been tradit ionally used as an adjunctive therapy in severe ulcerative colitis pat ients. We performed a prospective study to ascertain the safety, nutri tional efficiency, tolerance and costs of total enteral nutrition in t his situation. Methods: After 48 hours of intensive medical treatment, severe ulcerative colitis patients initiated enteral feeding with a p olymeric formula. The formula concentration and volume were increases daily. Results: 17 patients (7 women, 10 men; age 36,8+/-12,8 years) w ith a mean clinical activity score of 15,6+/-1,5 were included. In 14 patients (82,4%) enteral nutrition was well tolerated, attaining in 11 of them more than 80% of the caloric requirements by day 4. In 3 case s we observed vomiting and bloating. Prealbumin levels improved signif icantly from 11,1+/-3,4 mg/dl to 22,7+/-6,8 mg/dl (p = 0.002) at the e nd of enteral nutrition (11,8+/-4,7 days). Albumin and other nutrition al parameters did not change. Conclusion: total enteral nutrition coul d be considered a safe and well tolerated nutritional support in these patients. Although albumin and other nutritional parameters did not c hange during the study period, the increase in prealbumin levels sugge sts a favourable anabolic effect of total enteral nutrition.