text:
@article{
   title = {Orofacial granulomatosis},
   journal = {Lancet},
   volume = {338},
   number = {8758},
   pages = {20-1},
   note = {Editorial
England
Lancet. 1991 Jul 6;338(8758):20-1.},
   keywords = {Crohn Disease/complications
Food Hypersensitivity/complications
Humans
*Melkersson-Rosenthal Syndrome/drug therapy/etiology/pathology},
   ISSN = {0140-6736 (Print)
0140-6736},
   Accession Number = {1676087},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Andel, M. and Filip, K. and Brucek, P.},
   title = {[Long-term home parenteral nutrition using a totally implanted cannulation system]},
   journal = {Cas Lek Cesk},
   volume = {131},
   number = {13},
   pages = {395-8},
   note = {Andel, M
Filip, K
Brucek, P
Case Reports
English Abstract
Journal Article
Czech Republic
Cas Lek Cesk. 1992 Jul 10;131(13):395-8.},
   abstract = {A 29-year-old patient suffering from stenosis of the rectum and a periproctal fistula due to a severe form of Crohn's disease was completely fed by the parenteral route for 15 months, incl. 13 months at home, via a totally implanted cannula system Implantofix, Braun Co.. The patient felt throughout the period of parenteral nutrition very well, he worked and the secretion from the fistula stopped after four weeks. After 15 months of complete parenteral nutrition and elimination of oral food intake a marked improvement of the local finding in the rectum was observed. All laboratory findings (haemogram, liver tests, urea, creatinine, transferrin, albumin, cholinesterase and pre-albumin, serum levels of sodium, potassium, chlorides, calcium and phosphates) were throughout the observation period within a normal range. The body weight of the patient increased during the 15 months by 1 kg. The described case is the first one where domiciliary parenteral nutrition was used in Czechoslovakia under ambulatory conditions.},
   keywords = {Adult
*Catheters, Indwelling
Crohn Disease/therapy
Humans
Male
*Parenteral Nutrition, Home Total
Subclavian Vein},
   ISSN = {0008-7335 (Print)
0008-7335},
   Accession Number = {1504994},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Barclay, G. R. and McKenzie, H. and Pennington, J. and Parratt, D. and Pennington, C. R.},
   title = {The effect of dietary yeast on the activity of stable chronic Crohn's disease},
   journal = {Scand J Gastroenterol},
   volume = {27},
   number = {3},
   pages = {196-200},
   note = {Barclay, G R
McKenzie, H
Pennington, J
Parratt, D
Pennington, C R
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
England
Scand J Gastroenterol. 1992;27(3):196-200.},
   abstract = {The effect of dietary yeast on the activity of stable Crohn's disease was assessed in 19 patients. During the 1st month patients continued their usual diet (base-line period), but during the next 2 months dietary yeast was excluded except that during 1 month patients took baker's yeast capsules while for the other month they took placebo capsules. The patients' mean Pettit Crohn's disease activity index (CDAI) while taking baker's yeast (mean, 107.9; SE, 6.1) was significantly greater than during yeast exclusion (mean, 102.1; SE, 5.7; p less than 0.05). The mean of each patient's maximum CDAI during yeast exclusion (mean, 107.1; SE, 5.7) was significantly lower than those during the base-line (mean, 115.2; SE, 6.1; p less than 0.05) and baker's yeast inclusion periods (mean, 113.9; SE, 6.7; p less than 0.05). Patients with elevated yeast antibodies tended to develop a higher CDAI while receiving baker's yeast (13 of 15). These results suggest that dietary yeast may affect the activity of Crohn's disease.},
   keywords = {Adult
Antibodies, Fungal/*analysis
Crohn Disease/drug therapy/*immunology
Double-Blind Method
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Saccharomyces cerevisiae/*immunology
Yeast, Dried/*administration & dosage},
   ISSN = {0036-5521 (Print)
0036-5521},
   Accession Number = {1502481},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Bazzi, C. and Sinico, R. A. and Petrini, C. and Rizza, V. and Torpia, R. and Arrigo, G. and Ragni, A. and D'Amico, G.},
   title = {Low doses of drugs able to alter intestinal mucosal permeability to food antigens (5-aminosalicylic acid and sodium cromoglycate) do not reduce proteinuria in patients with IgA nephropathy: a preliminary noncontrolled trial},
   journal = {Nephron},
   volume = {61},
   number = {2},
   pages = {192-5},
   note = {Bazzi, C
Sinico, R A
Petrini, C
Rizza, V
Torpia, R
Arrigo, G
Ragni, A
D'Amico, G
Clinical Trial
Journal Article
Switzerland
Nephron. 1992;61(2):192-5.},
   abstract = {In an uncontrolled trial, patients with IgA nephropathy (IgAN) were treated with drugs that can alter the intestinal mucosal permeability to food antigens. These drugs are known to ameliorate urinary abnormalities and histological lesions of IgAN associated with ulcerative colitis or Crohn's disease [5-aminosalicylic acid (5-ASA)] or to prevent, in mice, the induction of IgAN-like disease by oral immunization [disodium cromoglycate (SCG)]. Nine patients [serum creatinine (s-Cr) less than 2 mg/dl; 24-hour proteinuria higher than 1.5 g, but not nephrotic) were treated with 5-ASA (2.4 g/day for 6 months); 9 similar patients were treated with SCG (400 mg/day for 6 months); the follow-up extended to 6 months after stopping therapy. The 5-ASA group showed a slight but not significant decrease in s-Cr, 24-hour/proteinuria, IgA circulating immune complexes (IgA-CIC) and IgA rheumatoid factor (IgA-RF); serum beta 2-microglobulin and serum IgA were unchanged; 2 of 9 treated patients showed, after 6 months of therapy, a reduction in proteinuria of more than 50% that lasted for the subsequent 18 months. The SCG-treated group showed a slight but not significant increase in 24-hour proteinuria and a significant decrease in serum IgA; unchanged were s-Cr, IgA-CIC, IgA-RF, serum beta 2-microglobulin; no patient treated with SCG showed a reduction in proteinuria of more than 50%. At the dosages and for the periods used, 5-ASA and SCG did not show a significant influence on clinical and laboratory parameters of disease in IgAN; other trials with increased dosages are warranted to definitely ascertain the possible therapeutic role of these drugs in IgAN.},
   keywords = {Adult
Aminosalicylic Acids/*pharmacology
Antigens/metabolism
Cromolyn Sodium/*pharmacology
Female
Food
Glomerulonephritis, IGA/*drug therapy/urine
Humans
Intestinal Mucosa/drug effects/immunology
Male
Mesalamine
Middle Aged
Permeability/drug effects
Proteinuria/drug therapy/urine},
   ISSN = {1660-8151 (Print)
1660-8151},
   Accession Number = {1630544},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Bresson, J. L. and Schmitz, J.},
   title = {Malnutrition in Crohn's disease: substrate deficiency or misuse?},
   journal = {Horm Res},
   volume = {38 Suppl 1},
   pages = {76-8},
   note = {Bresson, J L
Schmitz, J
Journal Article
Review
Switzerland
Horm Res. 1992;38 Suppl 1:76-8.},
   abstract = {Growth failure is frequently associated with Crohn's disease. However, it does not seem to be fully accounted for by overt endocrinological abnormalities or nutrient deficiencies. It may be related to an abnormal utilization of available substrates, particularly proteins, due to an imbalance in protein metabolism kinetics. Its primary mechanism may be an increase in protein breakdown rates over synthesis, specifically related to the associated inflammatory syndrome, and progressively leading to a protein debt. Reduction in food intake would only exaggerate this trend by further reducing the synthesis to breakdown ratio, whereas nutrient supplementation merely compensates for the deficit by promoting protein synthesis.},
   keywords = {Child
Crohn Disease/*complications/diet therapy/metabolism
Growth Disorders/diet therapy/etiology/metabolism
Growth Hormone/secretion
Humans
Insulin-Like Growth Factor I/metabolism
Nutrition Disorders/diet therapy/*etiology/metabolism
Proteins/metabolism},
   ISSN = {0301-0163 (Print)
0301-0163},
   Accession Number = {1295818},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Chuah, S. Y. and Jayanthi, V. and Lee, C. N. and McDonald, B. and Probert, C. S. and Mayberry, J. F.},
   title = {Dietary fats and inflammatory bowel disease in Asians},
   journal = {Ital J Gastroenterol},
   volume = {24},
   number = {7},
   pages = {386-8},
   note = {Chuah, S Y
Jayanthi, V
Lee, C N
McDonald, B
Probert, C S
Mayberry, J F
Journal Article
Italy
Ital J Gastroenterol. 1992 Sep;24(7):386-8.},
   abstract = {Chemically processed, hydrogenated fats, such as margarine, have been implicated in the aetiology of inflammatory bowel disease. Toxic by-products may occur in their production or during frying and cooking. A survey of dietary oil usage was conducted among Asians in Leicester, comparing inflammatory bowel disease patients with healthy controls. Two groups were comparable for age, sex, religion, place of birth, number of years spent in Britain and vegetarian status. There were no significant differences in actual oils used between healthy controls and patients with ulcerative colitis or Crohn's disease (chi 2 = 0.142 and 1.803 respectively, p greater than 0.50). However patients with Crohn's disease were found to recycle their cooking oil significantly more often than age and sex-matched colitics (p less than 0.05) and particularly age and sex-matched controls (p less than 0.01). A similar study needs to be conducted in India where the incidence of inflammatory bowel disease is low. If this difference is confirmed a programme of health education in cooking habits could lower the incidence of Crohn's disease.},
   keywords = {Dietary Fats/administration & dosage/*adverse effects
*Ethnic Groups
Humans
India/ethnology
Inflammatory Bowel Diseases/ethnology/*etiology
United Kingdom},
   ISSN = {0392-0623 (Print)
0392-0623},
   Accession Number = {1392019},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Cooke, D. M.},
   title = {Inflammatory bowel disease: primary health care management of ulcerative colitis and Crohn's disease},
   journal = {Nurse Pract},
   volume = {16},
   number = {8},
   pages = {27-30, 35-6, 38-9},
   note = {Cooke, D M
Journal Article
Review
United States
Nurse Pract. 1991 Aug;16(8):27-30, 35-6, 38-9.},
   abstract = {Inflammatory bowel disease encompasses both ulcerative colitis and Crohn's disease, two conditions so alike clinically that they are frequently indistinguishable from one another. Inflammatory bowel disease occurs at a rate of approximately five per 100,000 people. It tends to cluster in families and is seen four to five times more often in Jewish Caucasians than in other Caucasians. The etiology is unknown. Increasing attention is being paid to autoimmune factors, genetic factors and food allergies, and the notion that inflammatory bowel disease has its roots in a psychological disorder continues to pale for want of empirically sound evidence. Disease pattern is one of remission and exacerbation. The aim of therapy is to maintain an optimal lifestyle in remission through an individually tailored protocol of medications. Sulfasalazine remains the medication of choice; corticosteroids have short-term utility in exacerbation; and immunosuppressants, though controversial, are thought to have some steroid-sparing benefits during acute flare-ups. Indications for surgery vary, depending on whether or not a clear differential diagnosis has been made between ulcerative colitis and Crohn's disease. There is no cure for inflammatory bowel disease except for total colectomy in clearly diagnosed ulcerative colitis. Current research endeavors seek a cause or causes for inflammatory bowel disease, but the literature does not solidly support any one possibility above other rival etiologies.},
   keywords = {Colitis, Ulcerative/diagnosis/*nursing/therapy
Crohn Disease/diagnosis/*nursing/therapy
Diagnosis, Differential
Diet Therapy
Drug Therapy
Humans
*Nurse Practitioners
Prognosis},
   ISSN = {0361-1817 (Print)
0361-1817},
   Accession Number = {1923008},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Cravo, M. and Camilo, M. E. and Correia, J. P.},
   title = {Nutritional support in Crohn's disease: which route?},
   journal = {Am J Gastroenterol},
   volume = {86},
   number = {3},
   pages = {317-21},
   note = {Cravo, M
Camilo, M E
Correia, J P
Journal Article
United States
Am J Gastroenterol. 1991 Mar;86(3):317-21.},
   abstract = {Nutritional and clinical responses to three nutritional regimens were retrospectively evaluated in 81 Crohn's patients with active disease. Group 1 (n = 42) received a low residue oral diet, group 2 (n = 15) received chemically defined diets, and group 3 (n = 24), parenteral nutrition (PN). Weight gain was observed in a similar percentage of patients, whereas serum albumin increase was significant only in group 3: 3.15 +/- 0.66 versus 3.54 +/- 0.61 g/100 ml (p less than 0.05). Mean activity index decreased significantly in all groups (p less than 0.001), and length of stay in hospital was similar. Patients with intestinal obstruction had a better immediate response when submitted to PN: clinical remission was achieved in 75% of those in group 3, but in only 50% in groups 1 and 2 (p less than 0.05). Otherwise, short- and long-term outcome was similar.},
   keywords = {Acute Disease
Adolescent
Adult
Crohn Disease/blood/complications/*diet therapy
Female
*Food, Formulated
Humans
Length of Stay
Male
Middle Aged
*Parenteral Nutrition, Total
Retrospective Studies
Serum Albumin/analysis
Time Factors
Weight Gain},
   ISSN = {0002-9270 (Print)
0002-9270},
   Accession Number = {1900143},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Cunningham, A. S. and Jelliffe, D. B. and Jelliffe, E. F.},
   title = {Breast-feeding and health in the 1980s: a global epidemiologic review},
   journal = {J Pediatr},
   volume = {118},
   number = {5},
   pages = {659-66},
   note = {Cunningham, A S
Jelliffe, D B
Jelliffe, E F
Comparative Study
Journal Article
Review
United States
J Pediatr. 1991 May;118(5):659-66.},
   abstract = {PIP: In view of the significant and articulate minority view among pediatricians that breast feeding is not "worth the bother" in developed countries, this review of the literature delves into the evidence from both developed and developing countries for the advantages of breastfeeding, both in infants and for long-term health. Infants in developed settings experience twice the hospitalization rate and more severe illness from lower respiratory tract infection, primarily respiratory syncytial virus. In developing countries the mortality risk is 4-fold. for otitis media, the relative risks were 3.3-4.3 for Finnish infants. Bacterial meningitis and/or bacteremia had a 4-fold risk for hospitalization in a Connecticut study, and a 3-fold relative risk in 2 developing country studies. Human milk was the best preventative for bacteremia and necrotizing enterocolitis in prematures in British neonatal units. A 20-fold reduction in neonatal deaths occurred in Philippine study of breastfeeding, especially in low birth weight babies. Diarrhea causes the most infant mortality in developing nations, where bottle-feeding raises rates 14-fold. In the U.S. estimated relative risks is 3.7 for diarrheal mortality. Sudden infant death is about 1/5 less common in U.S. breast fed babies than in bottle fed. There is evidence for better long-term health after breast feeding in disorders such as celiac disease, Crohn disease, ulcerative colitis, insulin-dependent diabetes mellitus, thyroid disease, malignant lymphoma, chronic liver disease, atopic dermatitis, and food allergies. The design of good studies of protection conferred by breast feeding, and the possible modes of action of breast milk are discussed.
eng},
   keywords = {*Breast Feeding
*Global Health
*Health Status
Humans
Infant
Infant Mortality
Infant, Newborn
Meningitis/epidemiology
Otitis Media/epidemiology
Respiratory Tract Infections/epidemiology
Risk Factors
Sepsis/epidemiology
*Bacterial And Fungal Diseases
Biology
*Bottle Feeding--complications
*Breast Feeding--beneficial effects
Demographic Factors
Dermatitis
*Developed Countries
*Developing Countries
*Diabetes Mellitus
Diarrhea
*Diarrhea, Infantile
Diseases
*Eczema
Health
*Human Milk
*Infant Mortality
Infant Nutrition
Infections
*Lactation
*Literature Review
*Liver Dysfunction
*Longterm Effects
*Maternal Physiology
*Morbidity
Mortality
*Neonatal Diseases And Abnormalities
*Neoplasms
Nutrition
Physiology
Population
Population Dynamics
*Pulmonary Effects
*Risk Factors
Time Factors
*Viral Diseases},
   ISSN = {0022-3476 (Print)
0022-3476},
   Accession Number = {2019919},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Dudrick, S. J. and Latifi, R. and Schrager, R.},
   title = {Nutritional management of inflammatory bowel disease},
   journal = {Surg Clin North Am},
   volume = {71},
   number = {3},
   pages = {609-23},
   note = {Dudrick, S J
Latifi, R
Schrager, R
Journal Article
Review
United States
Surg Clin North Am. 1991 Jun;71(3):609-23.},
   abstract = {The etiology and specific treatment of Crohn's disease and ulcerative colitis are unknown, and the treatment strategy for patients with inflammatory bowel disease is essentially symptomatic and supportive. The malnutrition that frequently accompanies inflammatory bowel disease is a manifestation of intestinal failure and should be vigorously corrected with total parenteral nutrition, elemental diets, or both. Evidence exists for the value of total parenteral nutrition and elemental diets as primary therapy for inflammatory bowel disease in selected patients. Judicious nutritional therapy remains a cornerstone in the adjunctive management of these patients.},
   keywords = {*Enteral Nutrition
*Food, Formulated
Humans
Inflammatory Bowel Diseases/*therapy
Nutrition Disorders/*therapy
*Parenteral Nutrition, Total},
   ISSN = {0039-6109 (Print)
0039-6109},
   Accession Number = {1904647},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Dupont, C. and Barau, E. and Molkhou, P.},
   title = {[Intestinal permeability disorders in children]},
   journal = {Allerg Immunol (Paris)},
   volume = {23},
   number = {3},
   pages = {95-103},
   note = {Dupont, C
Barau, E
Molkhou, P
English Abstract
Journal Article
Review
France
Allerg Immunol (Paris). 1991 Mar;23(3):95-103.},
   abstract = {The intestinal mucosa has a certain degree of "porosity", which allows some molecules and macromolecules that are not subject to active transport, to cross the intestinal wall and enter the blood circulation. This permeability of the intestinal mucosa, which depends mostly on the size of the molecule and the state of the mucosa, can be studied with the assistance of protein macromolecules in an allergy-immunological investigation, or with inert markers, so permitting evaluation of the state of integrity of the small intestine. The markers used are polyethylene glycols (PEG) of various molecular weights, Cr EDTA, the monosaccharide sugars mannitol or rhamnose and the disaccharide sugars lactulose or cellobiose. Study of the intestinal permeability to inert markers allows detection of coeliac or Crohn's disease. It can be repeated, especially at the time of food provocation tests needed in the diagnosis of food intolerances in pediatrics in the enteropathology to cows milk proteins, atopic dermatitis and irritable colon in children.},
   keywords = {Antigens/pharmacokinetics
Child
Child, Preschool
Colonic Diseases, Functional/complications
Dermatitis, Atopic/complications
Dietary Carbohydrates/pharmacokinetics
Dietary Proteins/pharmacokinetics
Food Hypersensitivity/complications/metabolism
Humans
Immune Tolerance
Infant
*Intestinal Absorption
Intestinal Mucosa/metabolism
*Malabsorption Syndromes/complications/diagnosis/metabolism
Milk Proteins/adverse effects
Polyethylene Glycols/pharmacokinetics},
   ISSN = {0397-9148 (Print)
0397-9148},
   Accession Number = {2069683},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Festen, H. P.},
   title = {Intrinsic factor secretion and cobalamin absorption. Physiology and pathophysiology in the gastrointestinal tract},
   journal = {Scand J Gastroenterol Suppl},
   volume = {188},
   pages = {1-7},
   note = {Festen, H P
Journal Article
Review
England
Scand J Gastroenterol Suppl. 1991;188:1-7.},
   abstract = {Intrinsic factor is produced by the gastric parietal cell. Its secretion is stimulated via all pathways known to stimulate gastric acid secretion: histamine, gastrin, and acetylcholine. There is, however, a different mode of secretion for both substances: atropine, vagotomy, and H2 receptor antagonists inhibit both intrinsic factor and acid secretion, but secretin and the hydrogen-potassium ATPase antagonist omeprazole have no effect on intrinsic factor while substantially reducing acid secretion. Cobalamin in food is bound to animal protein. Cobalamin deficiency due to inadequate dietary intake is rarely seen in extreme vegetarians (vegans). In the stomach cobalamin is liberated from its protein binding by peptic digestion and bound to R-proteins. Hypochlorhydria or achlorhydria, whether medically induced or not, may impair cobalamin uptake. The cobalamin-R-protein complex is split by pancreatic enzymes in the duodenum, where cobalamin is bound to intrinsic factor. Pancreatic insufficiency may lead to cobalamin deficiency. Lack of intrinsic factor is the commonest cause of cobalamin deficiency; very rarely, aberrant forms of intrinsic factor are produced, but the clinical syndrome is similar. Gram-negative anaerobe bacteria bind the cobalamin-intrinsic factor complex, and bacterial overgrowth of the small intestine diminishes cobalamin resorption. Parasitic infections with fish tape-worm and Giardia lamblia are also associated with cobalamin malabsorption. The cobalamin-intrinsic factor complex binds to the ileal receptors in the terminal ileum. Cobalamin absorption may be impaired after resection or by diseases affecting more than 50 cm of the terminal ileum, such as Crohn's disease, coeliac disease, tuberculosis, lymphoma or radiation. There is clearly a wide diversity in the aetiology of cobalamin deficiency, which requires a versatile diagnostic approach.},
   keywords = {Humans
*Intestinal Absorption/physiology
Intrinsic Factor/*secretion
Vitamin B 12/*metabolism/physiology
Vitamin B 12 Deficiency/etiology/physiopathology},
   ISSN = {0085-5928 (Print)
0085-5928},
   Accession Number = {1775933},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Finn, R.},
   title = {Food allergy--fact or fiction: a review},
   journal = {J R Soc Med},
   volume = {85},
   number = {9},
   pages = {560-4},
   note = {Finn, R
Journal Article
Review
England
J R Soc Med. 1992 Sep;85(9):560-4.},
   abstract = {Food sensitivity is a common condition presenting with various clinical syndromes including migraine, urticaria, gluten enteropathy, Crohn's disease and irritable bowel syndrome. It is a heterogeneous condition affecting different organ systems and is also aetiologically diverse with subgroups due to allergy, pharmacological reactions, enzyme deficiencies and psychological causes. Clinical acceptance of food sensitivity has been delayed by the use of dubious diagnostic techniques by a minority of practitioners and the lack of laboratory diagnostic tests, but several double blind studies have now fully validated the existence of food sensitivity syndromes. More widespread recognition of food sensitivity would be cost effective for the National Health Service.},
   keywords = {Food Hypersensitivity/classification/diagnosis/diet therapy/*etiology
Humans
Terminology as Topic},
   ISSN = {0141-0768 (Print)
0141-0768},
   Accession Number = {1433127},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Giaffer, M. H. and Cann, P. and Holdsworth, C. D.},
   title = {Long-term effects of elemental and exclusion diets for Crohn's disease},
   journal = {Aliment Pharmacol Ther},
   volume = {5},
   number = {2},
   pages = {115-25},
   note = {Giaffer, M H
Cann, P
Holdsworth, C D
Journal Article
Research Support, Non-U.S. Gov't
England
Aliment Pharmacol Ther. 1991 Apr;5(2):115-25.},
   abstract = {Previous studies have confirmed the therapeutic value of elemental diets in promoting remission in active Crohn's disease, but their long-term benefit has not been established. Twenty-seven patients with established Crohn's disease who attained clinical remission after four weeks of enteral feeding were followed prospectively for up to 36 months. Twenty of these were willing to be tested for specific food intolerance using a pre-defined dietary elimination protocol; the others continued on a normal unrestricted diet. Eighteen patients (67%) have since relapsed; 89% of the relapse occurred within the first 6 months. Of the 15 patients with colonic involvement, 12 (80%) relapsed by 6 months. In contrast only 3 of 11 with isolated small bowel disease experienced early relapse. Of the 14 patients who completed the process of dietary testing, 5 could not identify any trigger foods; the remaining 9 were maintained on exclusion diets, 3 of whom relapsed early. Of the 11 taking a normal diet, 9 relapsed. Disease duration, previous intestinal resection or prior steroid therapy did not affect the relapse rate. Eight patients (31%) obtained a long-term remission, mean 23 months (range 12-36 months), without any medication. Long-lasting remissions can be obtained in about one-third of patients with Crohn's disease following treatment with a defined formula diet. Colonic involvement is associated with a high early relapse rate.},
   keywords = {Adult
Crohn Disease/*diet therapy
Enteral Nutrition
Female
Food, Formulated
Humans
Male
Recurrence},
   ISSN = {0269-2813 (Print)
0269-2813},
   Accession Number = {1909583},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Ginsberg, A. L.},
   title = {Diet therapy for Crohn's disease},
   journal = {Mayo Clin Proc},
   volume = {67},
   number = {4},
   pages = {394-5},
   note = {Ginsberg, A L
Comment
Editorial
England
Mayo Clin Proc. 1992 Apr;67(4):394-5.},
   keywords = {Crohn Disease/*diet therapy
*Food, Formulated
Humans},
   ISSN = {0025-6196 (Print)
0025-6196},
   Accession Number = {1548959},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Goode, H. F. and Robertson, D. A. and Kelleher, J. and Walker, B. E.},
   title = {Effect of fasting, self-selected and isocaloric glucose and fat meals and intravenous feeding on plasma zinc concentrations},
   journal = {Ann Clin Biochem},
   volume = {28 ( Pt 5)},
   pages = {442-5},
   note = {Goode, H F
Robertson, D A
Kelleher, J
Walker, B E
Journal Article
England
Ann Clin Biochem. 1991 Sep;28 ( Pt 5):442-5.},
   abstract = {This study investigated the effect of fasting, self-selected meals and isocaloric oral glucose and fat meals and intravenous (i.v.) feeding on plasma zinc concentrations in men. Plasma zinc remained stable when volunteers fasted all day, but self-selected meals and 600 kCal of dextrose or fat emulsion caused significantly reduced plasma zinc concentrations [mean (SD) 12.1 (1.4), 12.3 (0.6) and 12.2 (0.7) mumol/L at 1400 h, respectively, compared with a fasting level of 13.9 (1.6) mumol/L at 0800 h, P less than 0.05]. In patients undergoing intravenous hyperalimentation, plasma zinc decreased from 12.0 (1.4) mumol/L at 0800 h to 10.0 (1.1) mumol/L at 1400 h [mean (SD), P less than 0.01]. These data show that both enteral and i.v. feeding cause a decline in plasma zinc and that glucose alone is not responsible for this post-prandial fall since ingestion of isocaloric amounts of glucose or fat have a similar effect.},
   keywords = {Circadian Rhythm
Crohn Disease/*blood/diet therapy
Dietary Carbohydrates/*pharmacology
Dietary Fats/*pharmacology
*Fasting
Humans
Male
Parenteral Nutrition
Self Administration
Serum Albumin/analysis
Spectrophotometry, Atomic
Zinc/*blood},
   ISSN = {0004-5632 (Print)
0004-5632},
   Accession Number = {1958045},
   DOI = {10.1177/000456329102800503},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Greenberg, G. R.},
   title = {Nutritional support in inflammatory bowel disease: current status and future directions},
   journal = {Scand J Gastroenterol Suppl},
   volume = {192},
   pages = {117-22},
   note = {Greenberg, G R
Journal Article
Review
England
Scand J Gastroenterol Suppl. 1992;192:117-22.},
   abstract = {Malnutrition is a frequent occurrence in patients with acute inflammatory bowel disease. Total nutritional support provided either parentally (TPN) or enterally (TEN) has been advocated not only as an adjunct for improving nutrition but also as primary therapy. For patients with acute Crohn's disease, short-term rates of remission after TEN are equivalent to TPN. Coupled with certain advantages when compared with TPN, including simpler administration, fewer side effects, and preservation of the intestinal mucosal barrier, TEN may therefore be the preferred route for nutrient delivery. Controlled trials indicate equivalent or superior efficacy when enteral polymeric diets are compared with elemental diets for inducing remission in acute Crohn's disease. Moreover, when provided as an elemental diet, TEN is as effective as corticosteroids for achieving remission in acute Crohn's disease, but corticosteroids appear to be more effective than polymeric diets. Although the provision of nutritional support rather than bowel rest is the major factor contributing to symptomatic improvement, the optimal nutrient composition and the precise mechanisms whereby nutritional support achieves clinical remission remain to be clarified. In contrast to Crohn's disease, nutritional support is not effective for achieving remission in patients with ulcerative colitis. Thus, enteral nutritional support is an effective therapy for the short-term management of acute Crohn's disease. Whether long-term remission is equivalent to treatment with drugs or surgery requires prospective evaluation. Future avenues of investigation also include defining the optimal nutrient composition and the underlying mechanisms that achieve maximal nutritional repletion, promote mucosal cell renewal, and potentially directly retard production of inflammatory mediators.},
   keywords = {Crohn Disease/therapy
*Enteral Nutrition
Food, Formulated
Humans
Inflammatory Bowel Diseases/*therapy
*Parenteral Nutrition},
   ISSN = {0085-5928 (Print)
0085-5928},
   Accession Number = {1439562},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Hillier, K. and Jewell, R. and Dorrell, L. and Smith, C. L.},
   title = {Incorporation of fatty acids from fish oil and olive oil into colonic mucosal lipids and effects upon eicosanoid synthesis in inflammatory bowel disease},
   journal = {Gut},
   volume = {32},
   number = {10},
   pages = {1151-5},
   note = {Hillier, K
Jewell, R
Dorrell, L
Smith, C L
Journal Article
Research Support, Non-U.S. Gov't
England
Gut. 1991 Oct;32(10):1151-5.},
   abstract = {The incorporation of the fatty acids in fish and olive oil into the colonic mucosa of patients with inflammatory bowel disease was examined during 12 weeks' dietary supplementation with the oils, and the influence on colonic mucosal prostaglandin and thromboxane generation was measured. With a dietary supplement of 18 g fish oil daily, concentrations of the major polyunsaturated fatty acids in fish oil, eicosapentaenoic acid and docosahexaenoic acid, were significantly raised in mucosal lipids. The first time these were measured, after three weeks' supplementation, the mean increases in eicosapentaenoic and docosahexaenoic acid were seven fold and 1.5 fold respectively, and these increases were maintained during the 12 week study. Arachidonic acid values fell throughout the study and this reduction was significant at 12 weeks. Mucosal prostaglandin E2 (PGE2), thromboxane B2, and 6-keto prostaglandin F1 alpha synthesis were suppressed, and this reached significance (p less than 0.05) at three and 12 weeks for PGE2 and at 12 weeks for thromboxane B2. The predominant fatty acid in olive oil is oleic acid. Supplementation with 18 g/day resulted in a significant increase in oleic acid in colonic mucosa at 12 weeks (p less than 0.05) and a fall in stearic acid and docosahexaenoic acid; there was no significant change in eicosanoid synthesis. It is concluded that colonic lipids and prostaglandin and thromboxane synthesis can be readily altered by dietary supplementation with fish oil. The extent of incorporation of the fatty acids present in oils is dependent upon the individual fatty acid.},
   keywords = {Adult
Aged
Colitis, Ulcerative/metabolism
Colon/*metabolism
Crohn Disease/metabolism
Dietary Fats, Unsaturated/*metabolism
Eicosanoids/*biosynthesis
Female
Fish Oils/*metabolism
Humans
Inflammatory Bowel Diseases/*metabolism
Intestinal Mucosa/metabolism
Male
Middle Aged
Olive Oil
Plant Oils/*metabolism},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {1955170},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Igarashi, Y.},
   title = {[Parenteral and enteral nutrition in children with intestinal disease]},
   journal = {Nihon Rinsho},
   volume = {49 Suppl},
   pages = {683-8},
   note = {Igarashi, Y
Journal Article
Japan
Nihon Rinsho. 1991 Nov;49 Suppl:683-8.},
   keywords = {Age Factors
Amino Acids/administration & dosage
Child
Child, Preschool
Colitis, Ulcerative/diagnosis/*therapy
Combined Modality Therapy
Crohn Disease/diagnosis/*therapy
Diagnosis, Differential
Energy Intake
*Enteral Nutrition
Food, Formulated
Humans
Infant
*Parenteral Nutrition, Total},
   ISSN = {0047-1852 (Print)
0047-1852},
   Accession Number = {1798180},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Jaschonek, K. and Clemens, M. R. and Scheurlen, M.},
   title = {Decreased responsiveness of platelets to a stable prostacyclin analogue in patients with Crohn's disease. Reversal by n-3 polyunsaturated fatty acids},
   journal = {Thromb Res},
   volume = {63},
   number = {6},
   pages = {667-72},
   note = {Jaschonek, K
Clemens, M R
Scheurlen, M
Journal Article
United States
Thromb Res. 1991 Sep 15;63(6):667-72.},
   keywords = {Blood Platelets/*drug effects
Crohn Disease/*blood/diet therapy
Dietary Fats, Unsaturated/*pharmacology
Drug Stability
Fatty Acids, Unsaturated/*pharmacology
Fish Oils/*therapeutic use
Humans
Iloprost/*metabolism
Receptors, Epoprostenol
Receptors, Prostaglandin/*drug effects},
   ISSN = {0049-3848 (Print)
0049-3848},
   Accession Number = {1723538},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Koop, I.},
   title = {[Do patients with acute Crohn disease profit from enteral nutrition with oligopeptide diet?]},
   journal = {Z Gastroenterol},
   volume = {30},
   number = {5},
   pages = {344-5},
   note = {Koop, I
Journal Article
Germany
Z Gastroenterol. 1992 May;30(5):344-5.},
   keywords = {Acute Disease
Crohn Disease/*therapy
Enteral Nutrition/*methods
*Food, Formulated
Humans
Oligopeptides/*administration & dosage},
   ISSN = {0044-2771 (Print)
0044-2771},
   Accession Number = {1632117},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Kushner, R. F.},
   title = {Should enteral nutrition be considered as primary therapy in acute Crohn's disease?},
   journal = {Nutr Rev},
   volume = {50},
   number = {6},
   pages = {166-9},
   note = {Kushner, R F
Comparative Study
Journal Article
Review
United States
Nutr Rev. 1992 Jun;50(6):166-9.},
   abstract = {Clinical trials indicate that elemental enteral diets are equally as effective as corticosteroid treatment for acute Crohn's disease; however, a clear efficacy of polymeric formulas has yet to be demonstrated. Moreover, the mechanism of action of enteral nutrition remains uncertain, and further study is needed to define the precise role of specialized enteral formulas in the long-term management of this disease.},
   keywords = {Acute Disease
Crohn Disease/drug therapy/*therapy
*Enteral Nutrition
Food, Formulated
Humans
Polymers},
   ISSN = {0029-6643 (Print)
0029-6643},
   Accession Number = {1407745},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Levine, J.},
   title = {Exogenous factors in Crohn's disease. A critical review},
   journal = {J Clin Gastroenterol},
   volume = {14},
   number = {3},
   pages = {216-26},
   note = {Levine, J
Journal Article
Review
United States
J Clin Gastroenterol. 1992 Apr;14(3):216-26.},
   abstract = {The etiology of Crohn's disease remains elusive. Though there may be a genetic predisposition to the disease, epidemiologic evidence suggests that environmental factors are important. The role of dietary components and enhanced intestinal permeability deserve more attention. From this review of past studies, this investigator believes that ingested compounds may play an important role in the pathogenesis of Crohn's disease. Silica and various silicates provide models of how dietary factors might cause the disease and explain some of its features.},
   keywords = {Cell Membrane Permeability/physiology
Crohn Disease/*etiology/pathology/physiopathology
Dietary Carbohydrates/adverse effects
Granuloma/pathology
Humans
Intestinal Mucosa/physiopathology
Risk Factors
Smoking/adverse effects
Toothpastes/adverse effects},
   ISSN = {0192-0790 (Print)
0192-0790},
   Accession Number = {1564297},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Lindberg, E. and Magnusson, K. E. and Tysk, C. and Jarnerot, G.},
   title = {Antibody (IgG, IgA, and IgM) to baker's yeast (Saccharomyces cerevisiae), yeast mannan, gliadin, ovalbumin and betalactoglobulin in monozygotic twins with inflammatory bowel disease},
   journal = {Gut},
   volume = {33},
   number = {7},
   pages = {909-13},
   note = {Lindberg, E
Magnusson, K E
Tysk, C
Jarnerot, G
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
England
Gut. 1992 Jul;33(7):909-13.},
   abstract = {To assess whether dietary antigens play a role in inflammatory bowel disease, 26 monozygotic twin pairs with inflammatory bowel disease and 52 healthy controls were investigated for serum antibodies (IgA, IgG, IgM) against ovalbumin, betalactoglobulin, gliadin, whole yeast (Saccharomyces cerevisiae) and yeast cell wall mannan. The twins were made up of five pairs concordant and nine pairs discordant for Crohn's disease, and two pairs concordant and 10 pairs discordant for ulcerative colitis. Two patients with Crohn's disease had a slight increase in disease activity, the others were in clinical remission. Two striking observations were made: first, individuals with ulcerative colitis were indistinguishable from healthy twins, and controls except for the response to gliadin. Both healthy and diseased twins had higher IgA levels to gliadin than controls. Second, twins who had developed Crohn's disease displayed higher antibody titres towards yeast cell wall mannan in particular, but also to whole yeast (Saccharomyces cerevisiae) of all antibody types (IgA, IgG, and IgM). In contrast, the response to gliadin, ovalbumin, and betalactoglobulin did not differ from healthy twins and was even lower than in the controls. The results argue against an increased systemic antigen presentation caused by an impaired mucosal barrier in the inflammatory bowel disease. Rather, they suggest that yeast cell wall material--that is, mannan, or some antigen rich in mannose and cross reacting with mannan, may play an aetiological role in Crohn's disease, but not in ulcerative colitis. The increases in IgA and IgM, as well as IgG suggest that local and systemic immune systems are selectively activated by antigen(s) present in the cell wall of baker's yeast.},
   keywords = {Adult
Aged
Cell Wall/immunology
Food Hypersensitivity/*immunology
Gliadin/immunology
Humans
Immunoglobulin A/*analysis
Immunoglobulin G/*analysis
Immunoglobulin M/*analysis
Inflammatory Bowel Diseases/*immunology
Lactoglobulins/immunology
Mannans/immunology
Middle Aged
Ovalbumin/immunology
Saccharomyces cerevisiae/*immunology
*Twins, Monozygotic},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {1644330},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Lindor, K. D. and Fleming, C. R. and Burnes, J. U. and Nelson, J. K. and Ilstrup, D. M.},
   title = {A randomized prospective trial comparing a defined formula diet, corticosteroids, and a defined formula diet plus corticosteroids in active Crohn's disease},
   journal = {Mayo Clin Proc},
   volume = {67},
   number = {4},
   pages = {328-33},
   note = {Lindor, K D
Fleming, C R
Burnes, J U
Nelson, J K
Ilstrup, D M
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
England
Mayo Clin Proc. 1992 Apr;67(4):328-33.},
   abstract = {Although defined formula diets may be useful for initial episodes of Crohn's disease, the effects of these diets on subsequent attacks of Crohn's disease or in conjunction with corticosteroids are unknown. To evaluate these issues, we studied 27 patients in a randomized prospective trial. Ten patients received only prednisone (group I), nine received only a defined formula diet (Vital HN [high nitrogen]) (group II), and eight received a combination of prednisone and Vital HN (group III). At the time of entry into the study, the groups were similar with respect to age, sex, Crohn's Disease Activity Index, previous and current treatments, anatomic site of disease, and nutritional status. After 1 month of treatment, we noted seven successes (70%) and three failures in group I (prednisone only), three successes (33%) and six failures in group II (Vital HN only), and six successes (75%) and two failures in group III (combination therapy). Four patients randomized to receive only Vital HN were unable or unwilling to tolerate the defined formula diet. Of the five patients who were able to take the defined formula diet for 1 month, however, three (60%) were successfully treated. The patients who received prednisone (groups I and III) responded better than did the patients who received only the defined formula diet. These results may be attributable to the use of a nonelemental diet or the treatment of patients who were not experiencing an initial attack of Crohn's disease or who had previously received corticosteroids. The expensive and often poorly tolerated defined formula diets should not be considered as a substitute for standard therapy with corticosteroids in Crohn's disease.},
   keywords = {Adult
Aged
Combined Modality Therapy
Crohn Disease/*therapy
Female
*Food, Formulated
Humans
Male
Middle Aged
Prednisone/*therapeutic use
Prospective Studies},
   ISSN = {0025-6196 (Print)
0025-6196},
   Accession Number = {1548947},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Lochs, H. and Steinhardt, H. J. and Klaus-Wentz, B. and Zeitz, M. and Vogelsang, H. and Sommer, H. and Fleig, W. E. and Bauer, P. and Schirrmeister, J. and Malchow, H.},
   title = {Comparison of enteral nutrition and drug treatment in active Crohn's disease. Results of the European Cooperative Crohn's Disease Study. IV},
   journal = {Gastroenterology},
   volume = {101},
   number = {4},
   pages = {881-8},
   note = {Lochs, H
Steinhardt, H J
Klaus-Wentz, B
Zeitz, M
Vogelsang, H
Sommer, H
Fleig, W E
Bauer, P
Schirrmeister, J
Malchow, H
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
United States
Gastroenterology. 1991 Oct;101(4):881-8.},
   abstract = {This study compared the effect of enteral nutrition as the sole therapy of active Crohn's disease with drug treatment. Patients with active Crohn's disease (Crohn's Disease Activity Index greater than 200) were randomized to receive either enteral nutrition with a liquid oligopeptide diet (n = 55) or a combination of 6-methylprednisolone, 48 mg daily, subsequently tapered, and sulfasalazine, 3 g daily (n = 52). The two groups were not different with respect to age, sex, body weight, location of disease, or treatment before the study. The severity of disease was similar at the beginning of the study in both groups [Crohn's Disease Activity Index (mean +/- SEM), 323 +/- 12 vs. 316 +/- 11]. Remission was defined as a decrease of the initial Crohn's Disease Activity Index by 40% or at least 100 points. Twenty-nine patients in the diet group and 41 patients in the drug group reached remission within 6 weeks of therapy (chi 2 test, P less than 0.01). The median elapsed time to remission was 30.7 days in the diet group compared with 8.2 days in the drug group (Mantel Cox, P less than 0.01). To determine whether one of these treatments was more beneficial for a subgroup of patients, the effectiveness of both treatments was analyzed separately in patients with very severe disease (initial Crohn's Disease Activity Index greater than 300) and less severe disease (initial Crohn's Disease Activity Index less than 300), and in patients with different disease location. However, no influence of initial disease activity or disease location on the effect of either treatment could be shown. These data show that enteral nutrition is less effective than a combination of 6-methylprednisolone and sulfasalazine in treating active Crohn's disease.},
   keywords = {Adult
Crohn Disease/epidemiology/*therapy
Drug Therapy, Combination
*Enteral Nutrition
Female
Food, Formulated
Humans
Male
Methylprednisolone/*therapeutic use
Remission Induction
Severity of Illness Index
Sulfasalazine/*therapeutic use
Time Factors},
   ISSN = {0016-5085 (Print)
0016-5085},
   Accession Number = {1679736},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Matsuyuki, M. and Matsukuma, Y. and Yamashita, F.},
   title = {[Home enteral nutrition in pediatric practice]},
   journal = {Nihon Rinsho},
   volume = {49 Suppl},
   pages = {751-5},
   note = {Matsuyuki, M
Matsukuma, Y
Yamashita, F
Case Reports
Journal Article
Japan
Nihon Rinsho. 1991 Nov;49 Suppl:751-5.},
   keywords = {Adolescent
Age Factors
Child
Child, Preschool
Crohn Disease/complications/*therapy
Enteral Nutrition/*methods
Female
Food, Formulated
Growth Disorders/etiology
Humans
Infant
Intubation, Gastrointestinal
Male},
   ISSN = {0047-1852 (Print)
0047-1852},
   Accession Number = {1798192},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Matuchansky, C.},
   title = {[Enteral feeding in adults: indications]},
   journal = {Rev Prat},
   volume = {41},
   number = {8},
   pages = {694-8},
   note = {Matuchansky, C
English Abstract
Journal Article
France
Rev Prat. 1991 Mar 11;41(8):694-8.},
   abstract = {In this overview article the author examines successively: (1) the effects expected from enteral nutrition in adults: general and/or local nutritional effects, temporary arrest in progressive intestinal lesions, partial intestinal function replacement; (2) indications in gastrointestinal and non-gastrointestinal pathologies and modalities of application to each indication (route of administration, elemental, semi-elemental or polymeric nutrients, incremental or non-incremental calorie intake, necessity or lack of necessity for addition of fibres, value of ambulatory methods); (3) results according to indications: chronic inflammatory intestinal diseases, notably Crohn's disease, short small bowel syndromes, fistulae and stomies, preoperative period in gastrointestinal surgery, support of heavy treatments in non-terminal cancers, hypermetabolic states, notably stress; (4) absolute or relative contraindications of enteral nutrition.},
   keywords = {Adult
Digestive System Diseases/*therapy
*Enteral Nutrition/contraindications
Enterostomy
Food, Formulated
Humans
Nutrition Disorders/*therapy},
   ISSN = {0035-2640 (Print)
0035-2640},
   Accession Number = {1902975},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Merkel, I. and Wald, A.},
   title = {Defined formula diet for Crohn's disease: can it be used as primary therapy?},
   journal = {Am J Gastroenterol},
   volume = {86},
   number = {9},
   pages = {1273-4},
   note = {Merkel, I
Wald, A
Journal Article
United States
Am J Gastroenterol. 1991 Sep;86(9):1273-4.},
   keywords = {Crohn Disease/*diet therapy
Food Additives/administration & dosage
*Food, Formulated
Humans
Organic Chemicals
Retrospective Studies},
   ISSN = {0002-9270 (Print)
0002-9270},
   Accession Number = {1882811},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Murray, F. E. and McNicholas, M. and Stack, W. and O'Donoghue, D. P.},
   title = {Impaired fatty-meal-stimulated gallbladder contractility in patients with Crohn's disease},
   journal = {Clin Sci (Lond)},
   volume = {83},
   number = {6},
   pages = {689-93},
   note = {Murray, F E
McNicholas, M
Stack, W
O'Donoghue, D P
Comparative Study
Journal Article
England
Clin Sci (Lond). 1992 Dec;83(6):689-93.},
   abstract = {1. The incidence of gallstones in patients with Crohn's disease is increased compared with that in healthy control subjects. This is in part due to reduced terminal ileal bile salt absorption and consequent increased cholesterol saturation in bile. The aim of this study was to evaluate gallbladder contractility, a second important factor in the pathogenesis of gallstones, in Crohn's disease. 2. Thirty patients with Crohn's disease and no known biliary tract disease and nine healthy control subjects were studied. After an overnight fast, gallbladder volume was determined by real-time ultrasonography before and 10, 20, 30, 40, and 50 min after ingestion of a standard liquid fatty meal. 3. Compared with healthy control subjects, patients with Crohn's disease had similar fasting gallbladder volumes (control, 18.7 +/- 2.3 ml; Crohn's disease, 18.2 +/- 2.3 ml). Percentage emptying was significantly impaired at 30, 40 and 50 min in patients with Crohn's disease compared with control subjects. Patients with Crohn's disease limited to the small bowel had gallbladder contractility that was comparable with that of control subjects, whereas in those with large-bowel disease, minimum residual gallbladder volume was significantly smaller than in control subjects. Patients with both large- and small-bowel Crohn's disease demonstrated the most marked abnormalities, with gallbladder volumes significantly larger than those of control subjects at 30, 40 and 50 min. Likewise, patients with Crohn's disease who had undergone previous bowel resection had impaired emptying at 30, 40 and 50 min.(ABSTRACT TRUNCATED AT 250 WORDS)},
   keywords = {Adult
Colitis/physiopathology
Crohn Disease/*physiopathology/surgery
Dietary Fats/*administration & dosage
Female
Gallbladder/*physiopathology
Gallbladder Emptying/physiology
Humans
Ileitis/physiopathology
Male
Time Factors},
   ISSN = {0143-5221 (Print)
0143-5221},
   Accession Number = {1336439},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Nagel, E. and Schattenfroh, S. and Buhner, S. and Bartels, M. and Guthy, E. and Pichlmayr, R.},
   title = {[Experimental damage of the epithelial layer of the ileum by dietary fats: transmission electron microscopy findings and their comparison with cell pathology in Crohn disease]},
   journal = {Z Gastroenterol},
   volume = {30},
   number = {6},
   pages = {403-10},
   note = {Nagel, E
Schattenfroh, S
Buhner, S
Bartels, M
Guthy, E
Pichlmayr, R
English Abstract
Journal Article
Germany
Z Gastroenterol. 1992 Jun;30(6):403-10.},
   abstract = {Regarding the unknown pathogenesis of Crohn's disease repeatedly the importance of diet has been accentuated. Epidemiological, biochemical and animal experimental results have focused on a possible relationship between the consumption of chemically processed, partial hydrogenated fats and the development of regional enteritis. In this context an experimental animal model in pigs was designed to analyze, whether transmission electron microscopic alterations of ileal mucosa could be induced by forage of chemically processed fats. By creation of a retroperistaltic ileal segment the contact time between chyme and intestinal mucosa was prolonged. Our underlying question was to what extent disorders of the intestinal barrier function could be compared to Crohn's disease. Present study concentrates on the epithelial-cell-layer. It was shown that in comparison to the control animals the lamina epithelialis mucosae of all animals after fat-feeding was characterized by: sublethal lesion of the enterocytes/crypt-epithelial cells (shortening and alteration of the microvilli, degeneration of mitochondria, formation of autophagocytic vacuoles); goblet cell hyperplasia and increased production of mucus; focal appearance of intraepithelial lymphocytes as well as presence of polymorphonuclear granulocytes in the epithelium; widening of the intercellular-space locally up to total loss of the functional structure of the epithelial-cell-layer. In total the picture can be evaluated as an inflammatory process of the ileal mucosa. It can be concluded, that chemically processed fats as used in the described experimental conditions could induce this process. The feature of mucosal damage shows obvious similarities to ultrastructural findings in Crohn's disease if compared.},
   keywords = {Animals
Crohn Disease/*pathology
Cytoplasmic Granules/ultrastructure
Dietary Fats/*adverse effects
Epithelium/pathology
Female
Granulocytes/pathology
Ileum/pathology
Intercellular Junctions/ultrastructure
Intestinal Mucosa/*pathology
Lymphocytes/pathology
Microscopy, Electron
Swine},
   ISSN = {0044-2771 (Print)
0044-2771},
   Accession Number = {1636272},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Nemrava-Cicak, S.},
   title = {[The role and importance of an elemental diet in the treatment of Crohn's disease in children]},
   journal = {Lijec Vjesn},
   volume = {114},
   number = {9-12},
   pages = {284-7},
   note = {Nemrava-Cicak, S
English Abstract
Journal Article
Review
Croatia
Lijec Vjesn. 1992 Sep-Dec;114(9-12):284-7.},
   abstract = {Crohn's disease plays an important role in children's pathology. There is an increase in its incidence last decades. The etiology of Crohn's disease isn't yet known. The aim of therapy is to induce remission of the symptoms and disease's activity. Drug treatment as well as surgical procedures according to the side-effects and short-lasting effect have not shown to be satisfactory so far. Very important feature of Crohn's disease is growth retardation as well as puberty delay what is even emphasized by corticosteroid therapy which these children are quite long on. Recent research has shown that an elemental diet is as effective as corticosteroid therapy in inducing remission. Its positive effect on growth has been especially emphasized. It is not still certain how the elemental diet acts. It is supposed that its useful effects are achieved by its complete absorption without the need for extra digestion, by bowel rest, hypoallergenicity, changing in intestinal microflora, by caloric intake and reducing protein exudation by a direct influence on the mucosa of the small intestine. Because of all previously mentioned the elemental diet is recommended as a treatment of choice, especially for the nonstenositing features of Crohn's disease of the small intestine.},
   keywords = {Child
Crohn Disease/*diet therapy
*Food, Formulated
Humans},
   ISSN = {0024-3477 (Print)
0024-3477},
   Accession Number = {1343134},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {O'Brien, C. J. and Giaffer, M. H. and Cann, P. A. and Holdsworth, C. D.},
   title = {Elemental diet in steroid-dependent and steroid-refractory Crohn's disease},
   journal = {Am J Gastroenterol},
   volume = {86},
   number = {11},
   pages = {1614-8},
   note = {O'Brien, C J
Giaffer, M H
Cann, P A
Holdsworth, C D
Journal Article
Research Support, Non-U.S. Gov't
United States
Am J Gastroenterol. 1991 Nov;86(11):1614-8.},
   abstract = {Sixteen patients with Crohn's disease who had symptoms uncontrolled by high-dose steroids (n = 11) or symptoms invariably appearing on reduction or withdrawal of immunosuppressive therapy (n = 5) were treated with elemental diet. After 4 wk of dietary treatment, 10 patients were in remission and off all medication. Seven continued to be well without treatment for a minimum of 6 months, and four for at least 1 yr. No patient who subsequently relapsed had further steroid-refractory symptoms. Of the six patients failing to respond to elemental diet, four with steroid-refractory disease required early resective surgery for symptom relief, and two continued with steroid therapy, one in much reduced dosage. Elemental diet can bring about a sustained remission in many patients with Crohn's disease dependent on or refractory to corticosteroids, and reduce the need for surgical intervention.},
   keywords = {Adolescent
Adult
Aged
Azathioprine/therapeutic use
Crohn Disease/*diet therapy/drug therapy
Drug Resistance
Drug Therapy, Combination
Female
Food Additives/administration & dosage
*Food, Formulated
Humans
Male
Middle Aged
Organic Chemicals
Prednisolone/*therapeutic use
Time Factors},
   ISSN = {0002-9270 (Print)
0002-9270},
   Accession Number = {1951239},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Persson, P. G. and Ahlbom, A. and Hellers, G.},
   title = {Diet and inflammatory bowel disease: a case-control study},
   journal = {Epidemiology},
   volume = {3},
   number = {1},
   pages = {47-52},
   note = {Persson, P G
Ahlbom, A
Hellers, G
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
United States
Epidemiology. 1992 Jan;3(1):47-52.},
   abstract = {We conducted a population-based case-control study of inflammatory bowel disease and dietary habits in Stockholm during 1984-1987. We obtained retrospective information about food intake 5 years previously by a postal questionnaire for 152 cases with Crohn's disease, 145 cases with ulcerative colitis, and 305 controls. The relative risk of Crohn's disease was increased for subjects who had a high (55 gm or more per day) intake of sucrose (relative risk = 2.6, 95% confidence interval = 1.4-5.0) and was decreased for subjects who had a high (15 gm or more per day) intake of fiber (relative risk = 0.5, 95% confidence interval = 0.3-0.9). The most striking finding was an increased relative risk of both Crohn's disease and ulcerative colitis associated with consumption of fast foods: the relative risk associated with consumption of fast foods at least two times a week was estimated at 3.4 (95% confidence interval = 1.3-9.3) for Crohn's disease and 3.9 (95% confidence interval = 1.4-10.6) for ulcerative colitis. Although coffee seemed to provide a protective effect for both diseases, there are reasons to consider this finding an artifact.},
   keywords = {Adolescent
Adult
Aged
Case-Control Studies
Coffee
Colitis, Ulcerative/*epidemiology/etiology
Crohn Disease/*epidemiology/etiology
*Diet
Dietary Carbohydrates
Dietary Fiber
Feeding Behavior
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Sweden/epidemiology},
   ISSN = {1044-3983 (Print)
1044-3983},
   Accession Number = {1313310},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Pezzana, A. and Boggio Bertinet, D. and Costantino, A. M. and Da Pont, M. C. and Pera, A.},
   title = {[Possibilities and limitations of nutritional support in Crohn disease]},
   journal = {Minerva Gastroenterol Dietol},
   volume = {38},
   number = {3},
   pages = {161-5},
   note = {Pezzana, A
Boggio Bertinet, D
Costantino, A M
Da Pont, M C
Pera, A
English Abstract
Journal Article
Review
Italy
Minerva Gastroenterol Dietol. 1992 Jul-Sep;38(3):161-5.},
   abstract = {Crohn's disease involves a great risk of malnutrition. Malabsorption, bacterial contamination, frequent abdominal surgery, meal-related pain, protein loss through the damaged mucosa contribute to creating nutritional problems. Malnutrition can worsen the outcome, both in medical and surgical patients, and deteriorate an often already altered immune response. Weight loss, low levels of blood protein, electrolytes, micronutrients and vitamins are usually related to the extension of the mucosal damage. Nutritional assessment can be difficult due to oedema and bleeding, who interfere with both clinical and laboratory evaluation. The exact amount of nitrogen, lipids, minerals stool loss can be useful. It is widely accepted the use of nutritional support in Crohn's disease, but many Authors do not agree concerning the route (enteral or parenteral) and the kind of nutrient to be used. Still controversial is the role of nutrition: just support or real therapy? Most recent hypothesis concerning the pathogenesis of Crohn's disease indicate food and/or bacterial antigens as involved in determining the pathology. The "bowel rest", considered for many years as a fasting period necessarily supported by parenteral nutrition, can also be obtained by the temporarily reduction or stop in presenting those antigens to the bowel mucosa. This new concept can be achieved not only by parenteral nutrition, but with an enteral elemental diet as well. The elemental diet contains all nutrients in the simplest way and thus succeeds in lowering or eliminating the antigenic power. The reported results seem to indicate an equivalence of enteral and parenteral nutrition; anyway enteral is advisable when feasible, being more physiological and less expensive and involving a lower risk of serious complications.(ABSTRACT TRUNCATED AT 250 WORDS)},
   keywords = {Acute Disease
Chronic Disease
Crohn Disease/*therapy
*Enteral Nutrition
Humans
*Parenteral Nutrition},
   ISSN = {1121-421X (Print)
1121-421x},
   Accession Number = {1299338},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Polk, D. B. and Hattner, J. A. and Kerner, J. A., Jr.},
   title = {Improved growth and disease activity after intermittent administration of a defined formula diet in children with Crohn's disease},
   journal = {JPEN J Parenter Enteral Nutr},
   volume = {16},
   number = {6},
   pages = {499-504},
   note = {Polk, D B
Hattner, J A
Kerner, J A Jr
Journal Article
United States
JPEN J Parenter Enteral Nutr. 1992 Nov-Dec;16(6):499-504.},
   abstract = {Growth failure is the most common extraintestinal manifestation of Crohn's disease in childhood, occurring in up to 50% to 88% of affected patients. Previous studies have shown malnutrition to be the most likely cause of the decrease in height and weight velocities in these children. The purpose of this study was to determine the effect of an intermittent defined formula diet on growth and disease activity in children with Crohn's disease and growth failure. Six Tanner stage I-II patients, mean age 13.6 years with height less than the 5th percentile or height velocity less than the 3rd percentile were enrolled in a 1-year prospective study. An isotonic, hydrolyzed whey, medium-chain triglyceride formula was given by nocturnal nasogastric infusion at a caloric equivalent of 50th percentile for age, as the exclusive nutrient source 1 out of 4 months during a 1-year period. A 2-week exclusion diet and a 2-week low-residue diet followed the defined formula diet before resuming the regular diet for 2 months. Patients served as their individual control based on observations of at least 1 year before the study. Height and weight velocity significantly increased. Prednisone intake significantly decreased, and significant improvement was seen in disease activity, albumin, and somatomedin C. The results indicate that an intermittent defined formula diet can improve growth failure and significantly decrease disease activity in children with Crohn's disease.},
   keywords = {Adolescent
Child
Crohn Disease/*diet therapy/physiopathology
Female
*Food, Formulated
Growth/*physiology
Humans
Male
Prospective Studies
Time Factors},
   ISSN = {0148-6071 (Print)
0148-6071},
   Accession Number = {1494204},
   DOI = {10.1177/0148607192016006499},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Raouf, A. H. and Hildrey, V. and Daniel, J. and Walker, R. J. and Krasner, N. and Elias, E. and Rhodes, J. M.},
   title = {Enteral feeding as sole treatment for Crohn's disease: controlled trial of whole protein v amino acid based feed and a case study of dietary challenge},
   journal = {Gut},
   volume = {32},
   number = {6},
   pages = {702-7},
   note = {Raouf, A H
Hildrey, V
Daniel, J
Walker, R J
Krasner, N
Elias, E
Rhodes, J M
Case Reports
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
England
Gut. 1991 Jun;32(6):702-7.},
   abstract = {A controlled trial was performed to compare enteral feeding with either an amino acid based feed or a whole protein feed as sole treatment for active Crohn's disease. Twenty four patients were studied (nine with ileal, 11 with ileocolonic, and four with colonic disease). Both feeds proved effective; nine of 13 patients randomised to receive the amino acid based feed were in clinical remission within three weeks as defined by a simple activity index compared with eight of 11 treated with the whole protein feed. Patients in clinical remission were then crossed over onto the other feed. None of the six patients who were changed to the whole protein feed relapsed over the subsequent three week period compared with three of seven patients who were changed to the amino acid based feed. In responders the median serum C reactive protein concentration fell from 21 mg/l (range 9-82) on entry to 6 mg/l (range 3-19) at six weeks. Seven patients relapsed within eight months of starting solid food (mean 3.7 months), while nine were still in remission (follow up period 3-9 months, median six months). Detailed studies of staged reintroduction of food and permitted food additives were carried out over a four year period in a patient with extensive stricturing small bowel Crohn's disease who had been brought into remission by open treatment with enteral feeding. Carrageenan, other permitted emulsifiers, bread, meat, potatoes, oranges, refined sugar, dairy produce, flour, and rice were all reintroduced without any objective ill effect, but green vegetables provoked a clinical and biochemical relapse within one week of introduction. Remission was rapidly achieved by switching back to the enteral feed but reintroduction of the low residue diet that had been previously tolerated produced a brisk relapse. Clinical and biochemical remission was again achieved by a return to the enteral feed but relapse again occurred with reintroduction of the low residue diet. These studies confirm the therapeutic effect of enteral feeding in Crohn's disease. This effect does not seem to be due to avoidance of whole protein, but the very low residue of chemically defined enteral feeds may be important, particularly in patients with intestinal strictures.},
   keywords = {Adult
Amino Acids/*therapeutic use
C-Reactive Protein/metabolism
Crohn Disease/blood/pathology/*therapy
Dietary Proteins/*therapeutic use
*Enteral Nutrition
Humans
Intestine, Small/pathology
Male},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {1905672},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Rigaud, D. and Cosnes, J. and Le Quintrec, Y. and Rene, E. and Gendre, J. P. and Mignon, M.},
   title = {Controlled trial comparing two types of enteral nutrition in treatment of active Crohn's disease: elemental versus polymeric diet},
   journal = {Gut},
   volume = {32},
   number = {12},
   pages = {1492-7},
   note = {Rigaud, D
Cosnes, J
Le Quintrec, Y
Rene, E
Gendre, J P
Mignon, M
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
England
Gut. 1991 Dec;32(12):1492-7.},
   abstract = {To determine whether an elemental diet or a polymeric defined formula diet would be more effective for treating active Crohn's disease, we conducted a prospective randomised clinical trial in 30 patients with active Crohn's disease unresponsive to steroids and/or complicated by malnutrition. They received a four to six week enteral nutrition course with either an elemental diet or a polymeric diet. Clinical remission occurred in 10 of the 15 patients on elemental diet compared with 11 of the 15 patients assigned to polymeric diet. Both groups showed similar improvements in nutritional status, biological inflammation, alpha 1 antitrypsin clearance, and colonoscopic lesions (diminished in 17 out of 24 patients). Most patients relapsed during the year after discharge. We conclude that enteral nutrition, whatever the diet, is an efficient primary therapy for active Crohn's disease but does not influence the long term outcome.},
   keywords = {Adult
Colon/pathology
Colonoscopy
Crohn Disease/metabolism/pathology/*therapy
Enteral Nutrition/*methods
Female
Follow-Up Studies
*Food, Formulated
Humans
Male
Nutritional Status/physiology
Prospective Studies},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {1773955},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Roy, R. N. and Russell, R. I.},
   title = {Crohn's disease & aflatoxins},
   journal = {J R Soc Health},
   volume = {112},
   number = {6},
   pages = {277-9},
   note = {Roy, R N
Russell, R I
Journal Article
England
J R Soc Health. 1992 Dec;112(6):277-9.},
   abstract = {An investigation to examine the relationship between Crohn's disease and aflatoxins, a group of structurally related toxic and carcinogenic metabolites, was carried out on 24 patients. Extracts of serum and urine from the patients were assayed qualitatively by thin layer chromatography and the Aflatest method, and quantitatively by fluorimetry. There was evidence that some patients suffering from Crohn's Disease, together with some having coeliac disease and ulcerative colitis, did have varying amounts of aflatoxins in their serum and urine. The presence of aflatoxins may have been due to exposure to food containing these toxins or inability of the patient to excrete aflatoxins on account of some gastro-intestinal derangement. Only long-term investigation would establish the link between dietary history and the presence of aflatoxins in these patients.},
   keywords = {Aflatoxins/*adverse effects/blood/urine
Chromatography, Thin Layer
Crohn Disease/blood/*epidemiology/urine
Fluorometry
Humans
Incidence
Pilot Projects
Risk Factors
Scotland/epidemiology},
   ISSN = {0264-0325 (Print)
0264-0325},
   Accession Number = {1469674},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Silk, D. B.},
   title = {Medical management of severe inflammatory disease of the rectum: nutritional aspects},
   journal = {Baillieres Clin Gastroenterol},
   volume = {6},
   number = {1},
   pages = {27-41},
   note = {Silk, D B
Journal Article
Review
England
Baillieres Clin Gastroenterol. 1992 Mar;6(1):27-41.},
   abstract = {It is clear that the nutritional state of patients with inflammatory bowel disease is often impaired and can be improved by the provision of nutritional support. Improvement in nutritional status can be achieved as effectively with enteral as with parenteral nutrition. Nutritional support appears to have no primary therapeutic effect in patients with ulcerative colitis. With regard to nutritional support in Crohn's disease, parenteral nutrition should be restricted to use as supportive rather than primary therapy. Available information now seems to suggest that most of the benefits of parenteral nutrition in Crohn's disease are related to an improvement in nutritional state rather than as primary therapy, and its use should be restricted to the treatment of specific complications of Crohn's disease, such as intestinal obstruction related to stricture formation or short bowel syndrome following repeated resection. Although some doubt exists over the efficacy of oligopeptide-containing elemental and polymeric enteral diets, the present evidence indicates that chemically defined free amino acid-containing elemental diets have primary therapeutic efficacy in the management of acute exacerbations of Crohn's disease. As such, these diets are worthy of therapeutic trial in patients with severe Crohn's disease involving the distal colon and rectum, particularly in those patients who are malnourished and who prove to be resistant to treatment with a combination of topical corticosteroids and 5-aminosalicylic acid-containing compounds. Clinicians should be aware, though, that the beneficial effects are likely to be restricted to the short term, with high relapse rates by 1 year, this being particularly so in patients with distal Crohn's proctocolitis (Teahon et al, 1988). Volatile fatty acid enemas clearly have potential in the management of patients with severe steroid-resistant proctitis. Finally, one of the most important observations made in recent years is the one concerning the large losses of nitrogen that will occur in patients with inflammatory bowel disease treated with corticosteroids in the absence of adequate protein intake (O'Keefe et al, 1989). Hopefully the days of treating patients with severe inflammatory bowel disease with high dose corticosteroids and a peripheral dextrose or dextrose-saline drip have passed into history.},
   keywords = {Colitis, Ulcerative/*therapy
Crohn Disease/*therapy
Dietary Fiber/*administration & dosage
*Enteral Nutrition
Food, Formulated
Humans
Nutritional Status
*Parenteral Nutrition, Total},
   ISSN = {0950-3528 (Print)
0950-3528},
   Accession Number = {1316793},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Singleton, J. W.},
   title = {Enteral feeding versus drug therapy in Crohn's disease: a continuing story},
   journal = {Gastroenterology},
   volume = {101},
   number = {4},
   pages = {1127-8},
   note = {Singleton, J W
Comment
Comparative Study
Editorial
United States
Gastroenterology. 1991 Oct;101(4):1127-8.},
   keywords = {Adult
Child
Crohn Disease/*therapy
*Enteral Nutrition
Food, Formulated
Humans
Methylprednisolone/*therapeutic use
Sulfasalazine/*therapeutic use},
   ISSN = {0016-5085 (Print)
0016-5085},
   Accession Number = {1679734},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Sitrin, M. D.},
   title = {Nutrition support in inflammatory bowel disease},
   journal = {Nutr Clin Pract},
   volume = {7},
   number = {2},
   pages = {53-60},
   note = {Sitrin, M D
Journal Article
Review
United States
Nutr Clin Pract. 1992 Apr;7(2):53-60.},
   abstract = {Many patients with the inflammatory bowel diseases, Crohn's disease, or ulcerative colitis have significant protein-calorie malnutrition and micronutrient deficiencies. Factors that contribute to these nutritional deficits include inadequate nutrient intake, malabsorption, excessive nutrient secretion across the diseased gastrointestinal tract, drug-nutrient interactions, and increased nutrient requirements. In this review, the use of enteral and parenteral nutrition support as primary therapy for active Crohn's disease and ulcerative colitis is discussed. Other roles for nutrition support in patients with inflammatory bowel disease, including preoperative nutrition support, nutritional treatment of intestinal fistulas and growth retardation, and home parenteral nutrition for gut failure, are also reviewed.},
   keywords = {Deficiency Diseases/etiology/*therapy
Enteral Nutrition/*methods
Humans
Inflammatory Bowel Diseases/*complications
Parenteral Nutrition/*methods
Protein-Energy Malnutrition/etiology/*therapy
Trace Elements/*deficiency},
   ISSN = {0884-5336 (Print)
0884-5336},
   Accession Number = {1294879},
   DOI = {10.1177/011542659200700253},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Steffes, C. and Fromm, D.},
   title = {Is preoperative parenteral nutrition necessary for patients with predominantly ileal Crohn's disease?},
   journal = {Arch Surg},
   volume = {127},
   number = {10},
   pages = {1210-2},
   note = {Steffes, C
Fromm, D
Journal Article
United States
Arch Surg. 1992 Oct;127(10):1210-2.},
   abstract = {We reviewed 46 consecutive patients with Crohn's disease predominantly affecting the ileum who specifically underwent right-sided ileocolectomy with primary anastomosis. All had a primary ileocolic anastomosis done by suture in a single-layer closed fashion. Of these 46 patients, 19.6% had overt intra-abdominal sepsis, 30.4% had prior surgery, and 95.7% were taking corticosteroid drugs just before their operation. The mean (+/- SE) age was 31.5 +/- 2.0 years. The serum albumin level was less than 35 g/L in 93.5% of patients; all had a hematocrit value less than 0.36, and 80.4% lost more than 15% of their normal body weight. No patient received parenteral nutrition either preoperatively or postoperatively. No change in the preoperative, intraoperative, or postoperative approach to treating patients with predominantly ileal Crohn's disease occurred during the 10-year period of review. There was a 2.2% incidence of perioperative complications (one superficial wound infection) and a 6.5% incidence of late (>1.49 months) complications (two suture sinuses and one wound abscess unassociated with a fistula). Our findings suggest that preoperative parenteral nutrition is unnecessary in the majority of patients with predominantly ileal Crohn's disease specifically undergoing right-sided ileocolectomy and primary ileocolic anastomosis.},
   keywords = {Adolescent
Adult
Anastomosis, Surgical/methods
Colectomy/methods
Crohn Disease/pathology/*surgery
Follow-Up Studies
Food, Formulated
Humans
Ileum/surgery
Middle Aged
*Parenteral Nutrition
Prednisone/therapeutic use
*Preoperative Care
Surgical Wound Infection/etiology},
   ISSN = {0004-0010 (Print)
0004-0010},
   Accession Number = {1417487},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Teahon, K. and Pearson, M. and Levi, A. J. and Bjarnason, I.},
   title = {Elemental diet in the management of Crohn's disease during pregnancy},
   journal = {Gut},
   volume = {32},
   number = {9},
   pages = {1079-81},
   note = {Teahon, K
Pearson, M
Levi, A J
Bjarnason, I
Case Reports
Journal Article
England
Gut. 1991 Sep;32(9):1079-81.},
   abstract = {Four patients with Crohn's disease were treated with an elemental diet during pregnancy. Two had active disease and two also had symptoms of small intestinal obstruction. All went into a clinical remission within a few days of starting treatment. Treatment periods varied from two to four weeks, and were followed by elemental diet as a supplement to normal food in two patients. At term, all delivered a healthy infant. These patients indicate that elemental diet is a safe form of treatment for Crohn's disease during pregnancy and may be considered as an alternative to conventional drug treatments which carry a theoretical risk of teratogenesis.},
   keywords = {Adult
Crohn Disease/*diet therapy
Female
*Food, Formulated
Humans
Pregnancy
Pregnancy Complications/*diet therapy},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {1916496},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Teahon, K. and Smethurst, P. and Pearson, M. and Levi, A. J. and Bjarnason, I.},
   title = {The effect of elemental diet on intestinal permeability and inflammation in Crohn's disease},
   journal = {Gastroenterology},
   volume = {101},
   number = {1},
   pages = {84-9},
   note = {Teahon, K
Smethurst, P
Pearson, M
Levi, A J
Bjarnason, I
Journal Article
United States
Gastroenterology. 1991 Jul;101(1):84-9.},
   abstract = {This study examines whether treatment of acute Crohn's disease with an elemental diet improves intestinal integrity and inflammation as assessed by a 51Cr-labeled ethylenediaminetetraacetatic acid (EDTA) permeability test and the fecal excretion of 111In-labeled autologous leukocytes, respectively. Thirty-four patients with active Crohn's disease completed a 4-week treatment course with an elemental diet. Active disease was characterized by increased intestinal permeability [24-hour urine excretion of orally administered 51Cr-EDTA, 6.4% +/- 0.6% (mean +/- SE); normal, less than 3.0%] and by high fecal excretion of 111In-labeled leukocytes (14.2% +/- 1.1%; normal, less than 1.0%). Twenty-seven (80%) went into clinical remission, usually within a week of starting treatment. After 4 weeks of treatment, there was a significant decrease in both the urine excretion of 51Cr-EDTA (to 3.4% +/- 0.5%; P less than 0.01) and the fecal excretion of 111In (to 5.7% +/- 1.0%; P less than 0.001), indicating that such treatment is not just symptomatic. A framework for the mechanism by which elemental diet works, centering around the importance of the integrity of the intestinal barrier function, is proposed, and also appears to provide a logical explanation for some relapses of the disease.},
   keywords = {Acute Disease
Adolescent
Adult
Aged
Cell Membrane Permeability
Chromium Radioisotopes
Crohn Disease/*diet therapy/*metabolism/pathology
Edetic Acid
Female
*Food, Formulated
Humans
Indium Radioisotopes
Intestines/*metabolism
Leukocytes/metabolism
Male
Middle Aged},
   ISSN = {0016-5085 (Print)
0016-5085},
   Accession Number = {1904381},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Teahon, K. and Venkatesan, S.},
   title = {Fatty acid profile of plasma lipids from patients with Crohn's disease before and after 4 weeks on elemental diet ("O 28" or "Vivonex")},
   journal = {Biochem Soc Trans},
   volume = {19},
   number = {3},
   pages = {322s},
   note = {Teahon, K
Venkatesan, S
Clinical Trial
Comparative Study
Journal Article
England
Biochem Soc Trans. 1991 Aug;19(3):322S.},
   keywords = {Crohn Disease/*blood/diet therapy
Fatty Acids/blood
Food Additives/therapeutic use
*Food, Formulated
Humans
Lipids/*blood
Organic Chemicals
Phospholipids/*blood},
   ISSN = {0300-5127 (Print)
0300-5127},
   Accession Number = {1783157},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Thomas, A. G. and Miller, V. and Taylor, F. and Maycock, P. and Scrimgeour, C. M. and Rennie, M. J.},
   title = {Whole body protein turnover in childhood Crohn's disease},
   journal = {Gut},
   volume = {33},
   number = {5},
   pages = {675-7},
   note = {Thomas, A G
Miller, V
Taylor, F
Maycock, P
Scrimgeour, C M
Rennie, M J
Journal Article
Research Support, Non-U.S. Gov't
England
Gut. 1992 May;33(5):675-7.},
   abstract = {In order to investigate the effects of treatment on protein metabolism in childhood Crohn's disease whole body protein turnover was measured using a primed constant intravenous infusion of L-[1-13C]leucine and mass spectrometry in 10 children with active disease. Mean rates of protein synthesis and breakdown markedly decreased after treatment with steroids (four) or an elemental diet (six). This suggests that protein synthesis and breakdown are increased during active Crohn's disease in children and are reduced after induction of remission regardless of the type of treatment.},
   keywords = {Adolescent
Child
Crohn Disease/diet therapy/drug therapy/*metabolism
Energy Intake
Food, Formulated
Humans
Leucine/metabolism
Proteins/*metabolism
Steroids/therapeutic use},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {1612486},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {van Elburg, R. M. and Uil, J. J. and de Monchy, J. G. and Heymans, H. S.},
   title = {Intestinal permeability in pediatric gastroenterology},
   journal = {Scand J Gastroenterol Suppl},
   volume = {194},
   pages = {19-24},
   note = {van Elburg, R M
Uil, J J
de Monchy, J G
Heymans, H S
Journal Article
Review
England
Scand J Gastroenterol Suppl. 1992;194:19-24.},
   abstract = {The role of the physiologic barrier function of the small bowel and its possible role in health and disease has attracted much attention over the past decade. The intestinal mucosal barrier for luminal macromolecules and microorganism is the result of non-immunologic and immunologic defense mechanisms. The non-immunologic mechanisms consist of intraluminal factors such as gastric acid, proteolytic activity, and motility and of mucosal surface factors like mucin and the microvillous membrane. The immunologic mechanisms include secretary IgA and cell-mediated immunity. Both types of mechanism are not completely mature at birth. Maturation of this barrier is not finished before the 2nd year of life. One of the aspects of the mucosal barrier function can be estimated by the intestinal permeability (IP) for macromolecules. We use the differential sugar absorption test (SAT), in which the ratio of urinary excretion of a relatively large molecule, lactulose, is compared with that of a relatively small molecule, mannitol, after oral ingestion. Although the small intestine is permeable to certain macromolecules in normal developmental conditions, an increased IP could be involved in the pathophysiology of several diseases, including infectious diarrhea, food allergy, celiac disease, and Crohn's disease. It can be concluded that IP, as measured with the SAT, reflects the state of the mucosal barrier and is altered in several gastrointestinal diseases. The SAT is a non-invasive IP test that can be of diagnostic help to demonstrate alterations in the small-mucosal barrier function and may be useful to evaluate therapeutic interventions.(ABSTRACT TRUNCATED AT 250 WORDS)},
   keywords = {Animals
Child
Diarrhea/metabolism
Food Hypersensitivity/metabolism
Gastrointestinal Diseases/immunology/*metabolism
Humans
Immunity, Cellular
Immunoglobulin A, Secretory/analysis
Inflammatory Bowel Diseases/metabolism
Intestinal Mucosa/metabolism
Intestines/*metabolism
Permeability},
   ISSN = {0085-5928 (Print)
0085-5928},
   Accession Number = {1298042},
   year = {1992},
   type = {Ref–rence Type}
}

@article{
   author = {Wadworth, A. N. and Fitton, A.},
   title = {Olsalazine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in inflammatory bowel disease},
   journal = {Drugs},
   volume = {41},
   number = {4},
   pages = {647-64},
   note = {Wadworth, A N
Fitton, A
Journal Article
Review
New Zealand
Drugs. 1991 Apr;41(4):647-64.},
   abstract = {Olsalazine (sodium azodisalicylate; azodisal sodium) is an anti-inflammatory agent designed to deliver its active moiety, mesalazine (5-aminosalicylic acid; mesalamine), to the colon while avoiding the adverse effects associated with the use of a sulfapyridine carrier. As a prodrug, olsalazine is an effective oral treatment for both active ulcerative colitis and for maintenance of disease remission and may possibly be of benefit in patients with Crohn's colitis. Findings from both short and long term noncomparative and comparative studies demonstrate that olsalazine 1 to 3g daily in divided doses improves clinical signs and symptoms of colitis in approximately 60 to 80% of patients with acute ulcerative colitis of mild to moderate severity. This improvement rate was similar to that obtained with sulfasalazine. Lower doses of olsalazine, usually 1g daily in divided doses, also maintained remission in patients with chronic ulcerative colitis. While olsalazine effectively delivers mesalazine to the colon, the prodrug itself increases net luminal water secretion and accelerates gastrointestinal transit of a meal. The resulting diarrhoea (occurring in approximately 17% of patients and resulting in withdrawal from therapy in 6% of patients) is distinguishable from that associated with inflammatory bowel disease by the high water content and the absence of blood. Olsalazine-induced diarrhoea usually occurred soon after initiation of olsalazine therapy or dosage increase, was more frequent with higher doses and was usually transient. Dosage reduction, increases in frequency of dosing and concomitant administration with food reduced the severity in many patients with persistent olsalazine-induced diarrhoea. With the exception of diarrhoea, olsalazine was generally well tolerated. Fewer than 14% of patients allergic to or intolerant of sulfasalazine had similar reactions to olsalazine. Olsalazine appears to be a suitable therapy for the treatment of first attacks as well as acute exacerbation of mild to moderate acute ulcerative colitis, and for the maintenance of remission in patients with chronic ulcerative colitis.},
   keywords = {Aminosalicylic Acids/pharmacokinetics/pharmacology/*therapeutic use
Animals
Humans
Inflammatory Bowel Diseases/*drug therapy},
   ISSN = {0012-6667 (Print)
0012-6667},
   Accession Number = {1711964},
   year = {1991},
   type = {Ref–rence Type}
}

@article{
   author = {Wickbom, G. and Cha, S. O. and Danielsson, D. and Jarnerot, G.},
   title = {Experimentally induced ileal ulcers in rats. Formula diet is a preventive factor},
   journal = {Apmis},
   volume = {100},
   number = {8},
   pages = {762-4},
   note = {Wickbom, G
Cha, S O
Danielsson, D
Jarnerot, G
Journal Article
Research Support, Non-U.S. Gov't
Denmark
APMIS. 1992 Aug;100(8):762-4.},
   abstract = {We recently described an experimental model in the rat to create recurring chronic ileal inflammation including ulceration. This model is dependent on an "in vivo culture" of normal intestinal contents. In the present experimental study we examined the effect of a polymeric and a hydrolyzed formula diet on the formation of ulcerating lesions using our rat model. Two groups of rats (twenty in each group) were fed either one of these formula diets eight weeks prior to the experimental procedure and this diet was continued until sacrifice eight weeks later. Twenty control rats also underwent the experimental procedure but were fed standard rat pellets for the same time periods. At sacrifice 60% of the control rats had developed ileal ulcers. None of the rats fed the formula diets developed macroscopic ileal inflammation or ulceration. The effectiveness of formula diets in inducing remission in Crohn's disease in humans may be linked to alterations in the intestinal microflora. We hypothesize that the formula diets in this experiment exerted a protective effect against ileal ulceration by altering the ileal microflora. Preliminary studies support this hypothesis but need to be expanded.},
   keywords = {Animals
Disease Models, Animal
Female
*Food, Formulated
Ileal Diseases/*prevention & control
Ileitis/prevention & control
Rats
Rats, Inbred WF
Ulcer/prevention & control},
   ISSN = {0903-4641 (Print)
0903-4641},
   Accession Number = {1520487},
   year = {1992},
   type = {Ref–rence Type}
}

repository: KociOrges/pytag

repo_name: KociOrges/pytag