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Is fasting beneficial for hospitalized patients with inflammatory bowel diseases?

Intestinal Research 2020년 18권 1호 p.85 ~ 95
박용은 ( Park Yong-Eun ) - Yonsei University College of Medicine Department of Internal Medicine

박예현 ( Park Ye-Hyun ) - Yonsei University College of Medicine Department of Internal Medicine
박수정 ( Park Soo-Jung ) - Yonsei University College of Medicine Department of Internal Medicine
김태일 ( Kim Tae-Il ) - Yonsei University College of Medicine Department of Internal Medicine
김원호 ( Kim Won-Ho ) - Yonsei University College of Medicine Department of Internal Medicine
 ( Kim Jung-Nam ) - Yonsei University College of Medicine Department of Nutrition Care
 ( Lee Na-Rae ) - Yonsei University College of Medicine Department of Nutrition Care
천재희 ( Cheon Jae-Hee ) - Yonsei University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: Patients with inflammatory bowel disease (IBD) are usually hospitalized because of aggravated gastrointestinal symptoms. Many clinicians empirically advise these patients to fast once they are admitted. However, there has been no evidence that maintaining a complete bowel rest improves the disease course. Therefore, we aimed to investigate the effects of fasting on disease course in admitted patients with IBD or intestinal Behcet’s disease.

Methods: A total of 222 patients with IBD or intestinal Behcet’s disease, who were admitted for disease-related symptoms, were retrospectively analyzed. We divided them into 2 groups: fasting group (allowed to take sips of water but no food at the time of admission) and dietary group (received liquid, soft, or general diet).

Results: On admission, 124 patients (55.9%) started fasting and 98 patients (44.1%) started diet immediately. Among patients hospitalized through the emergency room, a significantly higher proportion underwent fasting (63.7% vs. 21.4%, P<0.001); however, 96.0% of the patients experienced dietary changes. Corticosteroid use (P<0.001; hazard ratio, 2.445; 95% confidence interval, 1.506?3.969) was significantly associated with a reduction in the disease activity score, although there was no significant difference between the fasting group and the dietary group in disease activity reduction (P=0.111) on multivariate analysis.

Conclusions: In terms of disease activity reduction, there was no significant difference between the fasting and dietary groups in admitted patients with IBD, suggesting that imprudent fasting is not helpful in improving the disease course. Therefore, peroral diet should not be avoided unless not tolerated by the patient.

키워드

Fasting; Inflammatory bowel disease; Intestinal Behcet’s disease; Colitis, ulcerative; Crohn disease
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