Elemental diets in the management of Crohn's perianal fistulae

Elemental diets have been used extensively in the routine management of patients with Crohn's disease during the past 2 years in this unit. We report our experience in 6 patients in whom perianal fistulae were present. Fistulae improved in 4 patients during elemental feeding; complete healing of fistulae occurred in one of them. No benefit was apparent in 2 patients, but in one the fecal stream had previously been diverted by transverse colostomy, and in the other fecal stasis was marked. The clinical significance of the observations and the difficulties of assessing diet therapy in this condition are discussed.