1Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
2Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
3Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India
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The authors received no financial support for the research, authorship, and/or publication of this article.
Conflict of Interest
No potential conflict of interest relevant to this article was reported.
Author Contribution
Conceptualization: Ahuja V. Methodology: Ahuja V, Kedia S. Formal analysis: Sharma S, Agarwal S. Project administration: Ahuja V. Visualization: Ahuja V, Sharma S, Kedia S. Writing-original draft: Sharma S, Agarwal S, Gupta A, Singh N, Vuyyuru SK, Kante B, Sahu P, Makharia G. Writing-review and editing: Ahuja V, Kedia S, Sharma S, Sharma R, Panwar R, Sahni P, Goyal S, Jain S, Gupta V. Approval of final manuscript: all authors.
Behavior of disease described according to Montreal classification: B1-inflammatory disease; B2-stricturing disease; B3-fistulizing disease; L1-terminal ileal disease; L2-colonic disease; L3-ileocolonic disease. Multivariate analysis not presented as only one factor was significant on univariate analysis.
EEN, exclusive enteral nutrition; CD, Crohn’s disease; OR, odds ratio; CI, confidence interval; CDAI, Crohn’s Disease Activity Index.
Variable | Cohort (n = 31) |
---|---|
Age (yr) | 34 ± 16 |
Sex, male/female | 17 (54.8)/14 (45.2) |
Duration of symptoms (mo) | 48 (18–72) |
B1 (inflammatory) | 4 (12.9) |
B2 (stricturing) | 18 (58.1) |
Inflammatory stricture | 8/18 (44.4) |
Fibrotic stricture | 10/18 (55.6) |
B3 (penetrating) | 9 (29.0) |
L1 (terminal ileal+cecal) | 12 (38.7) |
L2 (colonic) | 5 (16.1) |
L3 (ileocolonic) | 10 (32.3) |
L4 (proximal ileal and above) | 4 (12.9) |
Perianal disease | 5 (16.1) |
Previous treatment received | |
Corticosteroid | 30 (96.7) |
Azathioprine | 22 (70.9) |
Methotrexate | 6 (19.3) |
Anti-TNF-α agents | 5 (16.1) |
Surgery | 13 (41.9) |
Baseline investigations | |
Hemoglobin (g/dL) | 7.7 (6.5–8.0) |
Albumin (g/dL) | 2.5 (1.8–3.0) |
Baseline CDAI | 290 (260–320) |
Current treatment | |
Steroids+EEN | 6 (19.3) |
Azathioprine+EEN | 2 (6.5) |
Methotrexate+EEN | 1 (3.2) |
Anti-TNF-α therapy+EEN | 11 (35.5) |
EEN alone | 11 (35.5) |
Type of EEN | |
Semi-elemental | 23 (74.2) |
Polymeric | 8 (25.8) |
Duration of EEN (wk) | 4 (2–6) |
Variable | Baseline | 4 Weeks (post EEN) | P-value | 8 Weeks (post EEN) | P-value |
---|---|---|---|---|---|
CDAI | 290 (260–320) | 240 (180–280) | 0.001 | 186 (160–240) | 0.001 |
Hemoglobin (g/dL) | 7.7 (6.5–8.0) | 9.2 (8.0–10.0) | 0.001 | 9.8 (9.0–10.8) | 0.001 |
Albumin (g/dL) | 2.5 (1.8–3.0) | 3.2 (2.8–3.4) | 0.001 | 3.2 (3.0–3.6) | 0.001 |
Variable | OR (95% CI) for CDAI response | P-value |
---|---|---|
Disease duration | 1.000 (0.983–1.017) | 0.983 |
Phenotype of disease | ||
B1 vs. B2 | 1.880 (0.414–8.474) | 0.411 |
B1 vs. B3 | 4.345 (0.893–21.12) | 0.068 |
Site of disease | ||
L1 vs. L2 | 1.409 (0.309–6.398) | 0.659 |
L1 vs. L3 | 0.723 (0.211–2.475) | 0.605 |
CDAI (baseline) | 1.008 (1.002–1.017) | 0.046 |
Hemoglobin | 1.046 (0.840–1.564) | 0.389 |
Serum albumin | 1.369 (0.652–2.387) | 0.406 |
Type of EEN | ||
Semi-elemental | 1.050 (0.138–7.986) | 0.962 |
Polymeric | 1.782 (0.093–6.522) | 0.821 |
Values are presented as mean±standard deviation, number (%), or median (interquartile range). EEN, exclusive enteral nutrition; CDAI, Crohn’s Disease Activity Index; TNF, tumor necrosis factor.
Values are presented as median (interquartile range). CDAI, Crohn’s Disease Activity Index; EEN, exclusive enteral nutrition.
Behavior of disease described according to Montreal classification: B1-inflammatory disease; B2-stricturing disease; B3-fistulizing disease; L1-terminal ileal disease; L2-colonic disease; L3-ileocolonic disease. Multivariate analysis not presented as only one factor was significant on univariate analysis. EEN, exclusive enteral nutrition; CD, Crohn’s disease; OR, odds ratio; CI, confidence interval; CDAI, Crohn’s Disease Activity Index.