Parenteral Nutrition in Patients with Inflammatory Bowel Disease Systematic Review, Meta-Analysis and Meta-Regression

Nutrients. 2019 Nov 22;11(12):2865. doi: 10.3390/nu11122865.

Abstract

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the inflammation of the gastrointestinal tract. This study is to understand how the use of parenteral nutrition (PN) can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and meta-regression. From the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 119 registers with an accuracy of 16% (19 registers). After a full-text review, only 15 research studies were selected for qualitative synthesis and 10 for meta-analysis and meta-regression. The variables used were Crohn's Disease Activity Index (CDAI), albumin, body weight (BW), and postoperative complications (COM). PN has shown to have efficacy for the treatment of IBD and is compatible with other medicines. The CDAI and albumin improve, although the effect of PN is greater after a while. However, the effect on the albumin could be less than the observed value in the meta-analysis due to possible publication bias. The BW does not change after intervention. COM utilizing PN has been observed, although the proportion is low. More studies specifically referring to ulcerative colitis (UC) and Crohn's disease (CD) are needed to develop more concrete clinical results.

Keywords: Crohn disease; inflammatory bowel diseases; meta-analysis; parenteral nutrition; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Body Weight
  • Humans
  • Inflammatory Bowel Diseases / surgery
  • Inflammatory Bowel Diseases / therapy*
  • Malnutrition / therapy
  • Parenteral Nutrition*
  • Postoperative Complications
  • Regression Analysis
  • Serum Albumin, Human / analysis

Substances

  • Serum Albumin, Human