Only anecdotal experience exists on the use of elemental diets and total parenteral nutrition in fistulizing CD. Calam et al.  reported on six patients in whom an elemental diet was used specifically to treat perianal fistulae in Crohn's disease. Four improved with an elemental diet, but fistulae only healed completely in one patient. No studies specifically examined total parenteral nutrition in perianal CD. The use of elemental diets or total parenteral nutrition for fistulizing CD is therefore not recommended.
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