Nutritional care for patients with Crohn's disease.

Protein calorie malnutrition, in addition to deficits of other nutrients, occurs frequently among patients with Crohn's disease. In most instances the mechanisms by which these deficits occur are multifactorial. The most appropriate method to assess nutritional status includes a nutritionally oriented medical history and physical examination combined with a measurement of serum albumin. If the gut can be used safely, enteral nutrition is the preferred feeding method for Crohn's disease patients needing nutritional support. The advantages of enteral nutrition are stimulatory effects on gastrointestinal structure and function and reduced cost when compared to parenteral feeding. If the gastrointestinal tract cannot be used safely, parenteral nutrition is recommended. The presence of Crohn's disease among prepubertal children produces serious growth failure which can be reduced or arrested by appropriate nutritional interventions. Significant numbers of Crohn's disease patients ar now receiving both enteral and parenteral nutrition in the home setting.