Colitis, parenteral nutrition

Parenteral nutrition is an important component of the treatment of severe Crohn s disease or ulcerative colitis. The use of parenteral nutrition allows complete bowel rest in patients with severe ulcerative cohtis, which may alter the need for proctocolectomy. Parenteral nutrition has also been valuable in Crohn s disease, because remission may be achieved with parenteral nutrition in about 50% of patients. In some patients, the disease may worsen when parenteral nutrition is stopped. Patients with enterocutaneous fistulas of various etiologies benefit from parenteral nutrition. Parenteral nutrition may also be valuable in children or adolescents with growth retardation associated with Crohn s disease, but surgery is often necessary with severe disease. Finally, when possible, home parenteral nutrition should be used for patients requiring long-term therapy, particularly those with short gut as a consequence of surgical resection. 

Gonzalez-Huix F, Fernandez-Banares F, Esteve-Comas M, et al. Enteral versus parenteral nutrition as adjunct therapy in acute ulcerative colitis. Am J Gastroenterol 1993 88 227-232. 

Fig. 4. Bariiam enema of patient R.G. demonstrating the effect of parenteral nutrition on granulomatous colitis. A granulomatous process in lower segment of descending colon prior to therapy. B demonstrates healing 6 weeks after parenteral nutrition.

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