LB056 - THE CLINICAL BENEFIT AND PATIENT EXPERIENCE OF EXCLUSIVE ENTERAL NUTRITION FOR PRE-SURGICAL OPTIMISATION IN ADULT CROHN’S DISEASE

LB056

THE CLINICAL BENEFIT AND PATIENT EXPERIENCE OF EXCLUSIVE ENTERAL NUTRITION FOR PRE-SURGICAL OPTIMISATION IN ADULT CROHN’S DISEASE

K. Keetarut¹, I. S. Lei^1,2, J. Pagram^1,2, R. Shen^1,2, E. Papada^2,*

¹University College London Hospital NHS Foundation Trust, ²Division of Medicine, University College London, London, United Kingdom

Rationale: Up to eighty percent of patients with Crohn’s disease (CD) will require surgery during their disease course. Research shows pre-operative exclusive enteral nutrition (EEN) may reduce post-operative complications and improve clinical outcomes. This study aimed to evaluate surgical outcomes, post-operative events and patient experience of pre-operative EEN.

Methods: A service evaluation was conducted at a London teaching hospital by manually extracting data retrospectively from electronic records in patients diagnosed with CD who underwent elective ileal resection surgery including patients that had completed ≥4 weeks of pre-operative EEN. T-tests and chi-square tests were used to compare outcomes between EEN and non-EEN patients. Questionnaires were sent to all patients that had completed pre-operative EEN.

Results: Sixty-eight CD patients met the inclusion criteria. Post-operative events and complications occurred in 18.2% of adult CD patients receiving EEN pre-operatively compared with 7.7% in the non EEN patients (OR=2.67, 95% CI: 0.44-16.2, P=0.29). 27 patients completed the EEN experience questionnaire. Patients who received dietetic support pre-surgery indicated high adherence. Hunger (33.3%) was the most reported symptom during EEN with only 2 patients (7.4%) reporting poor palatability of EEN. The most reported psychosocial challenges during EEN were “missed eating food” (59.1%) and “missed eating with friends and family” (59.1%).

Conclusion: This study demonstrates that pre-operative EEN was not shown to improve clinical outcomes. It is suggested that patients chosen to receive EEN may have had pre-existing health issues potentially compromising their surgical outcomes. Increased  dietetic support was shown to improve adherence to EEN.

Disclosure of Interest: None declared