P622 Recovery of nutrient deficiency as a predictor of remission in inflammatory bowel diseases
A.A. Iakovlev, A. Volkov, I. Shcherbakova, G. Leonova, V. Piskovets
Rostov State Medical University, Department of Gastroenterology, Rostov-on-Don, Russian Federation
Background
Development of nutritional deficiency (ND) due to the loss of nutrients, water and electrolytes with frequent stools, nutrients malabsorption, anorexia and increased catabolism is typical for patients with IBD relapse. To determine the frequency and structure of ND in patients with IBD relapse and to evaluate the therapeutic effect of nutritional support (NS) of nutritive mixtures during the course of therapy.
Methods
Two-phase three-step study with prospective monitoring in patients with IBD was conducted during 3 years in the period from 2010 to 2012. The first phase was carried out using a one-time screening scales MUST and NRS, further in phase 2, the NS structure was refined. 520 patients with IBD were examined: 410 with ulcerative colitis (UC) and 110 with Crohn’s disease (CD).
Results
The first, 2d and 3d degree of ND were detected in 111 (27.1%), 96 (23.4%) and 42 (10.2%) patients with UC, respectively. 2d and 3d degree of ND was recorded in 48 (43.6%) and 29 (26.4%) cases in patients with CD, respectively. At the second stage of the study, 80 patients with UC were randomised into two major groups, depending on the degree of NN, were divided into groups A (2d degree of ND) and B (3d degree of ND). On basic therapy, patients of the Ist group received a diet with a high amount of protein (HAPD) and increased calorage (2500 kcal/day), while to the patients of the IId group in addition to the basic therapy, nutritional mixtures: peptamen and modulen IBD (Nestle) in the amount of 1/3 of the daily calorage were prescribed. Efficacy of treatment was evaluated on the 3 d, 4th, 12th week. At the third stage of the study, during 3 years, the long-term results were studied using index of the relapse frequency (IRF). Pick of the IRF was in the first group and by the end of the study, it was 15 (75%) and 17 (85%) cases, respectively. In the second group IRF was significantly lower: 9 (45%) and 12 (60%) (p <0,05).
Conclusion
In patients with UC and CD relapse ND of the first and 3d degree was recorded an average of 20.3% and 35%, respectively. The usе of NS provides a low-rate UC relapse, and thus stable remission of the disease.