[Experiences with home enteral nutrition using PEG in patients with adult Crohn's disease]

In adult cases with Crohn's disease, treatment of both the disease and patients' social lives is required for therapeutic regimens. Therefore, we assessed the safety and effectiveness of home enteral nutrition using PEG in patients with adult Crohn's disease. Five patients who were diagnosed with Crohn's disease undergoing a domiciliary treatment with enteral nutrition using PEG in The Jikei University School of Medicine and related institutions from May, 1994, to July, 1998, were the subjects of this study. All patients were relieved of symptoms and returned to work, one of whom relapsed two years later to undergo reoperation. Improvements of nutritional status and almost complete disappearance of inflammatory response were found in all patients. As for PEG-related complications, there was one case complicated with wound infection at an early time, and late complications, included two cases with abnormal granulation and one case with pain in ambient PEG. However, neither major complications nor complications that hindered everyday living were observed. Results of a questionnaire relating to this regimen showed almost complete well-being, though there were complaints about limited of oral intake and the cumbersome procedure of enteral nutrition. In conclusion, home enteral nutrition using PEG is effective in maintaining relief of symptoms, both the time required for feeding and patient pain are less, patients can be readily socially rehabilitated, and complications related to PEG have been few. These suggest that it may become a beneficial measure for patients with adult Crohn's disease.