“Surgery is frequently needed in Crohn’s Disease (CD) patients who have malnutrition. Patients with CD are at a risk of malnutrition secondary to decreased oral intake, malabsorption, and inflammation. The prevalence of malnutrition in IBD patients is profound: 60–80% of IBD patients are anemic, 39–81% are iron deficient, 20–60% are vitamin B12
deficient, 36–54% are folate deficient, and 25–80% have hypoalbuminemia. This high prevalence of malnutrition presents a challenge in the surgical management of CD patients because poor preoperative nutritional status has been linked to increase postoperative complications.
Therefore, nutritional optimization using enteral nutrition (EN) and total parenteral nutrition (TPN) have been used for many years to improve the nutritional status of CD patients in hopes of decreasing postoperative complications.”

“Preoperative nutrition supplementation with EN reduces postoperative complications in CD patients. EN in CD patients before undergoing surgery is superior to standard of care without nutrition support with a robust number needed to treat of 2. There is a trend toward TPN being superior to standard of care without nutrition support, but this trend did not reach statistical significance. Therefore, we recommend starting EN preoperatively in CD patients
undergoing planned surgery when possible and to consider preoperative parenteral nutrition in those with a contraindication to enteral feeding.”

Brennan, Gregory T et al. “Does preoperative enteral or parenteral nutrition reduce postoperative complications in Crohn’s disease patients: a meta-analysis.” European journal of gastroenterology & hepatology vol. 30,9 (2018): 997-1002. Full Text for Emory Users