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Meta-Analysis
. 2019 Nov 4;11(11):2657.
doi: 10.3390/nu11112657.

Enteral Nutrition in Patients with Inflammatory Bowel Disease. Systematic Review, Meta-Analysis, and Meta-Regression

Jose M Comeche  1 , Pablo Caballero  2 , Ana Gutierrez-Hervas  3 , Sofia García-Sanjuan  4 , Iris Comino  5 , Cesare Altavilla  6 , Jose Tuells  7
Affiliations
Meta-Analysis

Enteral Nutrition in Patients with Inflammatory Bowel Disease. Systematic Review, Meta-Analysis, and Meta-Regression

Jose M Comeche et al. Nutrients. .

Abstract

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and is characterized by inflammation of the gastrointestinal tract. One of the possible treatments for this pathology is a change in the type of diet, of which enteral nutrition (EN) is one. This study is to understand how the use of EN can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and a meta-regression. On the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 363 registers with an accuracy of 12% (44 registers). After a full-text review, only 30 research studies were selected for qualitative synthesis and 11 for meta-analysis and meta-regression. The variables used were Crohn's disease activity index (CDAI), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). EN has been shown to have efficacy for the treatment of Crohn's disease and is compatible with other medicines. As for the CDAI or rates of remission, there were no differences between enteral and parenteral nutrition. Polymeric formulas have shown better results with respect to the CRP. The long-term treatment could dilute the good CDAI results that are obtained at the start of the EN treatment.

Keywords: Crohn’s disease; enteral nutrition; inflammatory bowel diseases; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Identification and selection of the studies/records in the databases.
Figure 2
Figure 2
Chronological review according to the type of study and population.
Figure 3
Figure 3
Risk of bias summary across the clinical trials. Low risk of bias: green “+”; Some concerns of bias: yellow “?”, “!”; High risk of bias: red “−”.
Figure 4
Figure 4
Risk of bias graph across clinical trials. Low risk of bias: green; Some concerns of bias: yellow; High risk of bias: red.
Figure 5
Figure 5
Forest plot for the (a) Crohn’s disease activity index (CDAI), (b) C-reactive protein (CRP), (c) erythrocyte sedimentation rate (ESR). * Polymeric nutrition, # Elemental nutrition.
Figure 5
Figure 5
Forest plot for the (a) Crohn’s disease activity index (CDAI), (b) C-reactive protein (CRP), (c) erythrocyte sedimentation rate (ESR). * Polymeric nutrition, # Elemental nutrition.
Figure 6
Figure 6
Baujat plot for the (a) Crohn’s disease activity index (CDAI), (b) C-reactive protein (CRP), and (c) erythrocyte sedimentation rate (ESR). The correspondence between the study and the number is shown in Table 2 (ID, Omitting).
Figure 7
Figure 7
Funnel plot for the (a) Crohn’s disease activity index (CDAI), (b) C-reactive protein (CRP), and (c) erythrocyte sedimentation rate (ESR).
See this image and copyright information in PMC

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