Abstract
This study compares the effect of drug treatment for Crohn's disease with that of enteral nutrition alone as a therapeutic modality for this disease. Patients were randomly divided into two groups: One group (n = 52) was treated with 6-methylprednisolone (48 mg/day, subsequently tapered) and sulfasalazine (3 g/day). The second group (n = 55) was treated with enteral nutrition consisting of an oligopeptide diet. The two groups were matched for severity of illness and demographic characteristics. Remission was defined as a decrease in Crohn's Disease Activity Index by 40% (or at least 100 points). Significantly more (p < .01, χ 2) patients in the drug treatment group (41 of 52) achieved remission, compared with the dietary treatment group (29 of 55). The median time to remission for the drug treatment group was 8.2 days compared with 30.7 days for the dietary treatment group (p < .01; Mantel Cox). Further data analysis was carried out to determine whether certain subgroups within the dietary group might have benefited from this therapy (subgroups based on severity of initial disease activity or subgroups based on the anatomic location of the disease). This analysis did not demonstrate any influence of any of these factors on response to therapy in either group. This prospective randomized study demonstrates that enteral nutritional therapy alone is not as effective a therapeutic modality as drug therapy in patients with Crohn's disease.
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