[Adjuvant therapy with elemental diet in chronic inflammatory intestinal diseases. Comparative study]

Area of Science:

• Gastroenterology
• Clinical Nutrition
• Inflammatory Bowel Disease Research

Background:

• Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, presents significant challenges in patient management.
• Nutritional therapy, particularly elemental diets, is explored as an adjunct to conventional pharmacotherapy for IBD.
• Evaluating the efficacy of different molecular weights of elemental diets is crucial for optimizing treatment strategies.

Purpose of the Study:

• To compare the clinical efficacy of high-molecular versus low-molecular elemental diets in patients with active inflammatory bowel disease.
• To assess the impact of these diets on disease activity index, stool frequency, and erythrocyte sedimentation rate.
• To determine if one type of elemental diet offers superior benefits in managing Crohn's disease and ulcerative colitis.

Main Methods:

• A cohort of 26 in-patients with active inflammatory bowel disease (17 Crohn's disease, 9 ulcerative colitis) participated in the study.
• Patients received either a high-molecular (diet 1, n=12) or a low-molecular (diet 2, n=14) elemental diet, supplementing their existing drug treatment.
• Clinical parameters including disease activity index, stool frequency, erythrocyte sedimentation rate, body weight, and serum protein levels were monitored before and after dietary intervention.

Main Results:

• Both high- and low-molecular elemental diets led to significant reductions in disease activity index (from ~250s to ~80s) and stool frequency (from 5.6-7.1 to 0.9-2.0 per day).
• Erythrocyte sedimentation rate also decreased significantly in both diet groups, indicating reduced inflammation.
• No significant changes were observed in body weight, total protein, albumin, or red blood cell counts, and there was no statistically significant difference in outcomes between the two diet groups.

Conclusions:

• Both high-molecular and low-molecular elemental diets are effective in ameliorating disease activity and symptoms in patients with inflammatory bowel disease.
• The study suggests that low-molecular elemental diets may be a valuable addition to the treatment of chronic inflammatory bowel diseases.
• Further research is warranted to elucidate the specific mechanisms and long-term benefits of low-molecular elemental diets in IBD management.