Effect of a low-fat diet and antidiarrhoeal agents on bowel habits after excisional surgery for classical Crohn's disease.

The effect of dietary restriction and/or antidiarrhoeal agents on the bowel habits in relation to amount of ileal resection was studied in 63 patients after excisional surgery for classical Crohn's disease. Satisfactory function, i.e. one to three bowel movements per day was achieved in all patients with a moderate distal ileal resection (less than 100 cm) after such treatment. One quarter of these patients preferred codein phosphate or diphenoxylate and about one half a low fat diet, either alone or in combination with the above mentioned drugs. About one quarter did not need any form of anti-diarrhoeal therapy. In patients with a more extensive distal small bowel resection (greater than 100 cm), codein phosphate or diphenoxylate was mostly ineffective to control diarrhoea. However, by means of a low fat diet satisfactory bowel habits were achieved in the majority of these patients, although many of them had to combine this treatment with additional amounts of anti-diarrhoeal drugs. Thus, the result was considered unsatisfactory only in three of the 17 patients receiving such a treatment. Two of these patients were previously cholecystectomized however, and the third patient had been subjected to an almost 80% small bowel resection. Low fat diet appears to be an effective therapy for regulation of the disturbances in bowel function occurring after ileal resection and has a particularly important place in patients with extensive resections.