Short Peptide Enteral Nutrition Can Promote Spontaneous Healing Of Abdominal Enterocutaneous Fistula Caused By Crohn’s Disease

Crohn’s disease (CD) is a chronic, transmural, inflammatory disease of the gastrointestinal tract with unknown etiology. The idiopathic transmural inflammation characteristic of Crohn’s disease can lead to significant complications, such as the development of abscesses and fistulas. Though fistulas are common complication of CD, Fistulas are difficult to be tackled with, because of severity symptoms, infection and malnutrition. Nevertheless, enteral nutrition remains of interest in patients presenting concomitant malnutrition, or in those intolerant or who failed to other therapeutics. Enteral nutrition therapy in fistula patients of CD could facilitate the closure of fistula, reduce inflammatory marker levels markedly, improve the nutrition status effectively.Objective:Fistulas of crohn’s disease complication are often coupled with malnutrition. We evaluated the efficacy of enteral nutrition(EN) therapy for enterocutaneous fistulas in Crohn’s disease (CD).Methods:From May 2007 to December 2011,43 enterocutaneous fistula patients of CD who are treated with short peptide enteral nutrition for 3 months were retrospectively analyzed. The results of whether the fistula was closed or not were recorded after EN therapy. The closure time of fistulas were recorded as well. In order to evaluate the effect of EN on crohn’s fistula, we record the inflammation index (e. g. CRP、 ESR、Plt) and nutritional status indicators (e. g. body weight、BMI、(body mass index)、Hb、ALB、PALB、TP) before and after EN therapy. The follow-up time of the fistula cured patients were at least half a year.Results:27 of these 43 fistula patients were cured after EN therapy on the average of 32.6±9.2 days. Non-specific laboratory inflammation indices (ESR、CRP and Plt) of crohn’s disease were improved significantly after EN therapy when the patients were considered as a whole (P<0.05). Though the cured group and the unclosed group were both much better on inflammation indices after EN therapy, there were no significant differences between the two groups (P>0.05). The nutrition status of these patients, such as body weight、BMI、Hb、ALB、PALB and TP, increased significantly after therapy compared to that before treatment (P<0.05). The fistula cured group improved much better on serum albumin and serum prealbumin than the fistula unclosed group (P<0.05).Conclusions:EN therapy on enterocutaneous fistula of CD can achieve the results of closure of partial patients’ fistula, reduction of the inflammatory reaction, improvement of the nutrition status and avoiding the infliction of the operation.