Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials

Subgroup analysis comparing the effect of enteral versus parenteral nutrition on infectious complications in higher versus lower quality trials (with the median methodological score 7 as cutoff). CI confidence interval, EN enteral nutrition, M-H Mantel-Haenszel test, PN parenteral nutrition. (PDF 87 kb

Nutritional Advice

Inflammatory bowel disease has profound effects on the nutritional status of the patient. Multiple deficiencies of macro- and micronutrients have been described, especially in patients with Crohn’s disease. Uncontrolled studies have suggested that avoiding oral feeding - called bowel rest with total parenteral nutrition - induced remission of disease and closed fistulas. Controlled trials suggested that bowel rest did not aid the induction of remission but enteral feeding of defined formula diets did induce remission to the same degree as steroids in some but not all studies. Recently a controlled trial suggested the remission induced by a defined formula diet could be prolonged by the use of elimination diets. The use of specific nutrients capable of reducing inflammation or promoting epithelial integrity await study

Renal effects of long-term treatment with 5-aminosalicylic acid

BACKGROUND: A number of case reports link the use of 5-aminosalicylic acid (5-ASA) to interstitial nephritis in patients with inflammatory bowel disease (IBD)