潰瘍性大腸炎3症例に対する半消化態栄養剤を用いた食事療法の試み

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  • Trial of Dietary Therapy Using Polymeric Diet for 3 Cases of Ulcerative Colitis
  • カイヨウセイ ダイチョウエン 3 ショウレイ ニ タイスル ハンショウカタイ エイヨウザイ オ モチイタ ショクジ リョウホウ ノ ココロミ

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The clinical effects of dietary therapy (DT) were investigated using a low-residue/low-fat diet for breakfast and lunch (1000Kcal and less for breakfast and lunch together) and a polymeric diet alone (400-800 Kcal using Clinimeal) for dinner on 3 cases of moderate UC (total colitis-type UC [case 1: 15-year-old male], left-sided colitis-type UC [case 2: 58-year-old male; case 3: 66-year-old female]). 　　　　Results: Case 1: During the administration of salicylazosulfapyridine (SASP) 3 g/day in combination with a low-residue/ low-fat diet, bloody diarrhea relapsed every 1 hour. SASP 3 g/day and DT were used in combination, and 5 days after initiation of DT administration, no blood was observed macroscopically in stool, and diarrhea had changed to muddy stool. On day 8, the patient felt hunger. After 22 days of DT administration, Ulcerative Colitis Disease Activity Index (UCDAI) score was 11. About 3 months later, UCDAI score was 3. Case 2: During the administration of SASP 3 g/day in combination with a low-residue/low-fat diet, the second relapse of left-sided abdominal pain and bloody stool was noted. DT was initiated, along with the following: SASP 3 g/day alone for 25days, steroid drug 20 mg/day (rectal application) alone for 16 days, and SASP 1.5 g/day alone for 21 days. AT 1week after initiation of DT administration, the amount of blood in stool was reduced and the patient felt hunger. On day 44 of DT administration, UCDAI score was 7. On day 112 of DT administration, UCDAI score was 3. UCDAI score at third relapse was 7, but following Steronema enema once a day at bedtime in combination with DT administration for 11 days, and thereafter, with administration of a normal, low-residue/ low-fat diet, UCDAI score was 2 one month later. Case 3: 3 days before visiting this clinic, the patient noted soft, bloody stool 4-5 times in the morning. DT administration was begun without use of drugs. The amount of blood in stool decreased from day 1 of DT administration. UCDAI score on day 10 of DT administration was 8. Conclusion: It has been suggested that DT may attenuate inflammatory reaction.

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