[Total parenteral nutrition in inflammatory bowel disease. An evaluation of its clinical response]

We studied the effects of total parenteral nutrition (TPN) on the course of inflammatory bowel disease (IBD) which evaluation was still conflicting. Since 1972, in our department 32 courses of TPN were done for 27 patients with IBD. Definite improvement on nutritional status and clinical symptoms such as abdominal pain, diarrhea, vomiting was observed in most courses of TPN, especially for the patients with intestinal tuberculosis, non-specific multiple intestinal ulcers, and Crohn's disease. Clinical remission was obtained in 26 out of 32 courses of TPN (81.3%) on the short-term follow-up. But on the long-term follow-up ranging from 6 months to 11 years, 11 out of 20 patients (55%) were symptom-free without any medical treatment. Clinical relapse occurred in 6 patients and another TPN was required. These results suggest that TPN is useful as an adjunctive therapy for IBD patients requiring bowel rest and nutritional repletion. Two patients requiring prolonged TPN are returning to work with home parenteral nutrition (HPN) for 2.5 and 5 years respectively. HPN is safe and effective for improving life of quality in the patients receiving prolonged TPN.