The role of exclusive enteral nutrition in the pre-operative optimisation of adult patients with Crohn's disease. A systematic review

Ayeshah Gordon-Dixon, Jessica Gore-Rodney, Rumneek Hampal, Rose Ross, Anur Miah, Amanda Rodrigues Amorim Adegboye, Caris E. Grimes

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
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Abstract

Summary Aim To conduct a systematic review in order to bring together the current knowledge about the use of exclusive enteral nutrition (EEN) in the pre-operative optimisation of adult patients with Crohn's disease undergoing intestinal resection. Methods We searched Pubmed, Cochrane Library, ClinicalTrials.gov and the EU clinical trial register to identify experimental and observational studies on the effect of pre-operative EEN on nutritional and clinical outcomes of patients undergoing surgery. Methodological quality was assessed using the Downs and Black checklist. Results Seven studies were included in the final analysis. Of these 5 were retrospective cohort studies and 2 were retrospective case-control studies. There were 4 ongoing RCTs, however they have not reported data to analyse. Overall the 7 retrospective studies, support that with EEN; body mass index (BMI) does not increase, C-reactive protein decreases (CRP), albumin usually increases and haemoglobin does not significantly change. There were fewer infectious complications in patients who had taken EEN. There was a trend towards fewer stomas but only one of the studies was powered enough to demonstrate significance. There was no significant difference in recurrence rates of Crohn's disease at 12 months in any of the studies. Quality of the studies were either medium or poor. Conclusion The current data on the use of EEN in pre-operative optimisation is of poor quality and underpowered to demonstrate significance. Randomised controlled trials are needed to demonstrate whether or not EEN can improve outcomes and reduce stoma formation in adult patients undergoing intestinal resection.
Original languageEnglish
Pages (from-to)99-105
Number of pages7
JournalClinical Nutrition ESPEN
Volume46
Early online date12 Oct 2021
DOIs
Publication statusPublished - Dec 2021

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This document is the author’s post-print version, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it.

Keywords

  • Crohn's disease
  • Surgical resection
  • Enteral nutrition
  • Complications
  • Nutrition

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