Crohn's Disease: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 31: Dietary Manipulations: Parenteral Therapy for Crohn's Disease (continued)

Alan L. Buchman, MD, MSPH

There are few prospective and prospectively controlled trials that have evaluated the use of total parenteral nutrition (TPN) either as clinical observations or compared to medical therapy alone. TPN may also be used as supportive therapy in order to maintain normal nutritional status or to correct undernutrition in patients with severe CD and, much less commonly, severe UC. Indications for TPN as a supportive therapy in patients with CD include intestinal obstruction, bowel perforation, prolonged postoperative ileus, part of a regimen to treat enterocutaneous or enteroenteric fistulae…