[Energy expenditure of patients with Crohn's disease. Course study during hospitalization]

Weight loss and protein energy malnutrition are frequent in Crohn's disease. The increase of resting energy expenditure has been pointed out as the cause of these findings. In this study we report eleven patients with Crohn's disease, six women and five men hospitalized with active Crohn's disease. In three patients the disease involved the small bowel, in five the large bowel and three shared large and small bowel involvement. At the beginning of the hospitalization the activity disease index of Van Hees was 196 +/- 52, range: 132-265. The resting energy expenditure was eleven percent higher than that, of a healthy population (p: n.s). During hospitalization the energy expenditure decreased weekly with statistically significant difference. No relation has been observed between the activity index of Van Hees, and any of the energy parameters studied. Patients with body weight lower 90% of ideal weight, had an increased resting energy expenditure when that was expressed in kcal/kg of weight (p = 0.003). Fever was the sole parameter analyzed with statistically significant relation with consumption of oxygen: with the index of oxygen consumption (p = 0.03) and with the percentage of resting energy expenditure (p = 0.006). In summary, the REE in active Crohn's disease is higher than that of healthy population, although without statistically significance. The REE tends to normalization coinciding with the decreasing of inflammatory activity. Increased energy expenditure has been detected in weight loss patients.