Abstract
In order to evaluate the usefulness of and the problems associated with early enteral nutrition (EEN) in the patients with ulcerative colitis (UC), we performed a randomized controlled trial comparing EEN versus total parenteral nutrition (TPN). UC patients who underwent a total proctocolectomy and ileal pouch anal anastomosis with ileostomy or subtotal colectomy with ileostomy were randomized to receive EEN or TPN. Both types of nutritional therapy were continued till postoperative day (POD) 6. Although TPN could be completed with no side effect in all patients, EEN could not be continued till POD 6 in 46% of patients because of abdominal pain and nausea. The administered calories from POD 4 to POD 6 were significantly lower in the EEN not-completed group than in the EEN completed group and TPN group. The serum transthyretin level at POD 7 was also significantly lower in the EEN not-completed group. Although there was no significant difference in the frequency of postoperative complications between the two groups, the incidence of ileus was lower in the EEN group. In conclusion, it is essential for early postoperative recovery of rapid turnover protein to administer a sufficient amount of calories. The combination of low-dose EEN and TPN may be suitable for the postoperative nutritional therapy of UC patients.
