Malnutrition was included by Crohn as one of the features of the new disease he described. Most patients with Crohn's disease are malnourished even if their disease is not active. Nutritional factors may be implicated in the aetiology of the disease, but this remains unproven. The role of nutritional support and therapy is discussed and it is suggested that improving the patient's nutritional status may have a primary therapeutic as well as a supportive role in the treatment of the disease.
Crohn's disease is a chronic, transmural, inflammatory disorder of the alimentary tract, manifested by marked ill-health, gastrointestinal symptoms and, sometimes, life-threatening complications'. It is more common in northern Europe and North America than elsewhere in the world'. The highest reported incidence to date is 8.3 per 100000 population from Cardiff, and this is still increasing3. It is a disease that affects the young more than the elderly and females more than males4.', although this latter trend has only been noted in recent years6. It is a major cause of illness in the young. Since there is no known cure, they face a lifetime of illness, steroids and surgery.
Nutrition is intrinsically linked with Crohn's disease. Nutritional factors have been suggested as possible causes of the disease' ; malnutrition and nutritional deficiencies are common in patient^^.^; and nutritional therapy (both enteral and intravenous) has been advocated both as primary and as adjunctive treatment9-' '. Crohn's disease and its surgery are now the commonest cause of the short gut syndrome" and many affected patients require long-term home parenteral nutritionL3. Clearly, it is important to understand the role that nutrition plays in this disease.