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Background and Aims Changes in body composition have been described in patients with Crohn's disease, but their predictive performances on disease evolution remain undefined. The aims of our study were to assess, in patients with Crohn's disease requiring abdominal computed tomography, body composition by computed tomography, and to study the outcome according to various body composition parameters at the time of the computed tomography. Methods Patients with Crohn's disease who underwent abdominal computed tomography for suspected complications were retrospectively included. The definition of adverse outcome included death or need for surgery within 6 months of the computed tomography. Skeletal muscle index and visceral and subcutaneous adiposity indexes were calculated from tissue surface areas measured at the third lumbar vertebra, divided by the height squared. Results The prevalence of underweight was 26.8% and the prevalence of sarcopenia was 33.6%. After gender adjustment, skeletal muscle index tended to be reduced in patients with adverse outcome, compared with patients without surgery or death [p = 0.07]. Moreover, subcutaneous adiposity index and visceral adiposity index were significantly lower in patients with surgery or death [p = 0.009 and p < 0.001, respectively]. These differences were almost equivalent in both genders for the subcutaneous adiposity index but were clearly stronger in men for the visceral adiposity index. Conclusions Subcutaneous and visceral adiposity indexes correlate inversely with adverse outcome in patients with Crohn's disease. Alteration of body composition assessed by computed tomography in these patients appears to be a marker of disease severity.

Background : HPI or stool transplant has shown promising results in treatment of Clostridium difficile infection. It has also shown some efficacy in treatment of Ulcerative Colitis and being used as a modality of treatment at some centers outside United States. So far there is no data available about efficacy of this treatment modality. Also there is no data available regarding efficacy & patient's perception about this treatment method. Methods: In this study, we enrolled 16 patients with Ulcerative Colitis established with our Crohn's & Colitis clinic who performed home based HPI for their disease. A short telephone survey was conducted to understand patients' perception about HPI. Patients were asked to grade effectiveness of their therapy on scale of 1 to 5, 5 being most effective in achieving primary goal. Patient's medical records were reviewed to obtain pre-transplant disease factors such as pre-transplant medications, Lichtiger score. Results: The average age of recipient group was 33+/5 years, while the average age of donor group was 43+/-6 years. Out of 16 patients who performed HPI for their disease, 8 (50%) achieved their primary goal which was to avoid medications or to avoid surgery. Patients were divided into two groups based on scale of effectiveness of treatment. Group 1 (38%) with Patients with score of more than 3 and Group 2 (62%) with patients with score of less than 3. In group 1, average duration of disease was 5 years as compared to 13 years in group 2(p=0.05). In group 1, 60% patients were on steroids prior to transplant as compared to 30% in group 2. 50% patients were on biologics before transplant in group 1 as compared to 30% in group 2. Female: Male (F: M) ratio for recipient in group 1 was 5 as compared to 0.25 in group 2. (p=0.01) F: M ratio for donor in group 1 was 0.2 as compared to 2.3 in group 2 (p=0.03). Average Lichtiger score in group 1 was 8.8 as compared to 3.5 in group 2 (p=0.05). Conclusion: Human Probiotic Infusion helped 50% of patients in achieving their primary goal. Benefits were highest with female recipient and male donors. Patients with more severe disease (evident by higher Lichtiger score and use of steroid/ biologics) have better outcomes in terms of achieving primary goal.