Nutritional management of Crohn's disease with a peptide-based enteral formula

We examined a nutritional approach to the therapy of Crohn's disease with an enteral formula ('Enterued', Terumo Corporation, Tokyo, Japan) which contains low molecular weight peptides as a protein source. Total protein, albumin, transferrin, prealbumin and retinol-binding protein levels were significantly increased as indices of the nutritional status, when compared with those observed before treatment. White blood cell count (WBC), erythrocyte sedimentation rate and C reactive protein (CRP) as the indices of inflammation levels were reduced significantly after the termination of the treatment, when compared with those observed before treatment. The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) assessment scores decreased in all cases, except for one case out of 51 cases evaluated. Deterioration in nutritional status was not observed in any patient, but rather was maintained or improved; 42 out of the total 51 cases (82.4%) exhibited at least moderate improvement. Treatment was discontinued on account of side effects such as abdominal distension, abdominal pain and diarrhoea in five cases (8.1%). The enteral formula 'Enterued', utilizing low molecular weight peptides as a nitrogen source, appears to improve nutritional status and encourage remission of the inflammatory process with minimal side effects.