Crohn Disease: Schütz T

Lochs H, Dejong C, Hammarqvist F, Hebuterne X, Leon-Sanz M, Schütz T, van Gemert W, van Gossum A, Valentini L, Anonymous00249, Lübke H, Bischoff S, Engelmann N, Thul P, Anonymous00250. · Department of Gastroenterology, Charité-Universitätsmedizin, CCM, Berlin, Germany. · Clin Nutr. · Pubmed #16698129 No free full text.

Abstract: Undernutrition as well as specific nutrient deficiencies have been described in patients with Crohn's disease (CD), ulcerative colitis (UC) and short bowel syndrome (SBS). The present guideline gives evidence-based recommendations for the indication, application and type of formula of enteral nutrition (EN) (oral nutritional supplements (ONS) or tube feeding (TF)) in these patients. It was developed in an interdisciplinary consensus-based process in accordance with officially accepted standards and is based on all relevant publications since 1985. ONS and/or TF in addition to normal food is indicated in undernourished patients with CD or CU to improve nutritional status. In active CD EN is the first line therapy in children and should be used as sole therapy in adults mainly when treatment with corticosteroids is not feasible. No significant differences have been shown in the effects of free amino acid, peptide-based and whole protein formulae for TF. In remission ONS is recommended only in steroid dependent patients in CD. In patients with SBS TF should be introduced in the adaptation phase and should be changed with progressing adaptation to ONS in addition to normal food.

Schütz T, Drude C, Paulisch E, Lange KP, Lochs H. · Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Universitätsklinikum Charité Campus Mitte, Berlin, Deutschland. · Dig Dis. · Pubmed #14571099 No free full text.

Abstract: BACKGROUND: An increased intake of sucrose has been reported in patients with Crohn's disease (CD). Since subclinical zinc deficiency reduces taste perception for sweet, we investigated taste perception, sucrose intake and plasma zinc levels as well as dental status in CD patients. METHODS: Carbohydrate intake and plasma zinc levels were assessed in 24 CD patients and 24 age-matched controls (Con). Taste threshold for sucrose, oral hygiene and caries prevalence were evaluated. RESULTS: In CD a higher sucrose intake (CD 107.1 +/- 27.7 vs. Con 71.9 +/- 13.7 g/day; p < 0.001), a higher taste threshold for sweet (CD 7.31 vs. Con 2.91 g/l; p < 0.001) and lower plasma zinc levels (CD 11.5 +/- 1.5 vs. Con 13.5 +/- 2.0 micromol/l; p < 0.001) were found. API was poor (CD 85.4 +/- 23.6, Con 31.8 +/- 24.1, p < 0.001) and correlated with sucrose intake (p < 0.01). Caries prevalence was increased in patients with longer disease (>3 years) (DMFT index: >3 years 15.6 +/- 5.7 vs. <3 years 9.5 +/- 4.3; p < 0.05). CONCLUSION: Dental status in CD patients is poor. Both increased sugar consumption and insufficient oral hygiene seem to cause the higher caries prevalence. Obviously, patients with CD belong to a high-risk group, and preventive measures should be taken early in the course of the disease.