83 WHOLE BODY COMPOSITION AFTER ENTERAL NUTRITIONAL (EN) THERAPY IN PEDIATRIC CROHN'S DISEASE.

Enteral nutrition (EN) has become accepted treatment of acute Crohn's Discase (CD) and the malnutrition it produces in pediatric patients. Most patients on EN achieve substantial weight increase. We examined whether the weight gain in these patients represents an increase in body fat or lean body mass. Accordingly, we performed whole body composition using the Norland 2600 dichromatic densitomer with a ¹⁵³Gd radioisotope source (Norland Inc., Fort Atkinson, WI.) in 6 males and 4 females with acute CD at the start of treatment and after eight weeks of EN. Vital HN, a 1Kcal/cc semi-elemental formula (Ross Laboratories, Montreal) was delivered by NG tube at 80cc/kg/24 hr to a maximum of 3000cc/day. Patients were age 13.2 ± 2.1 yrs. All had ileal disease, 3 had additional bowel involvement and 1 colonic disease. Pts were acutely ill with a mean CDAI of 203.2 ± 67.9 Eight of 10 were treated concurrently with 5′ ASA medication. Two remained on low dose alternate day prednisone during EN. Table

Over this period of treatment, patients achieved a proportionately greater increase in body fat compared to lean body mass. There was a small but measurable increase in bone mineral content. While all of the measures improved as above, none of the results in this small population achieved a statistically significant rise. To determine efficacy of EN therapy, further observations are required in patients after a comparable period of treatment with corticosteroids.