Effect of intravenous nutrition on nutrition and function in acute attacks of inflammatory bowel disease

The effect of IV nutrition on protein nutriture and physiological function in 19 patients who were clinically malnourished and had acute exacerbations of inflammatory bowel disease was studied. Total body protein, plasma proteins, respiratory muscle function, and skeletal muscle function were measured at the commencement of a 14-day course of IV nutrition and 7 and 14 days later. Final measurements were made after recovery approximately 200 days later. Compared with a group of matched controls, the patients had lost approximately 35% of their body protein stores with accompanying physiological impairments of 20%-40%. After 4 days of IV nutrition, there were improvements in all the physiological measurements (approximately 12%) but no significant change in total body protein. During convalescence, there were further improvements in physiological function, which were accompanied by an increase in body stores of protein. We conclude that there is an early and rapid improvement in physiological function with IV nutrition in patients hospitalised for exacerbations of inflammatory bowel disease even though this is not accompanied by significant protein gain. Later during anabolic recovery, physiological improvements occur in association with repletion of total body protein. Short courses of IV nutrition in these patients prevent protein loss and result in significant improvements in skeletal muscle function and respiratory muscle function.