Fat-reduced diet in the symptomatic treatment of small bowel disease: Metabolic studies in patients with Crohn's disease and in other patients subjected to ileal resection

Abstract

Thirteen patients suffering from Crohn's disease or subjected to small bowel resection were studied under metabolic ward conditions for an average of 32 days. Most of these patients had chronic, severe diarrhoea and varying degrees of steatorrhoea. All were studied at two levels of fat intake, 100 g and 40 g daily. After the introduction of the low-fat diet, there was a marked reduction in the faecal excretion of water and sodium in most patients and 10 of them passed solid faeces. Two other subjects improved only after the addition of cholestyramine. In one patient with an ileostomy, no improvement occurred. On the low-fat diet, there was a positive balance of nitrogen and potassium in many cases. Faecal fat excretion decreased, but there was no change in the fractional absorption of fat. The most gratifying improvement was seen in patients with a functioning gallbladder. Previous resection of the colon seemed to limit the reduction of faecal water and sodium excretion which followed the reduction in fat intake. A fat-reduced diet is recommended in the symptomatic therapy of chronic diarrhoea in patients suffering from diseases of the ileum.