(1) Background: The CDED + PEN (partial enteral nutrition) is a promising method of nutritional treatment in active Crohn’s disease (CD). An increase in fecal calprotectin (FCP) level—a marker of mucosal inflammation—happens to be the first evidence of Crohn’s disease exacerbation that appears ahead of clinical symptoms and usually co-exists with them. In this study, we present our own experience with using the CDED + PEN in the treatment of children with CD and an increased FCP level. (2) Methods: In total, 48 children (male/female: 27/21) aged 4–17 years (median value = 13.43; IQR = 4.00) were treated with CDED + PEN between June 2019 and July 2021. The main inclusion criteria for the study was active CD defined as an FCP level ≥ 250.00 µg/g. Patients with severe clinical manifestation of CD (PCDAI >40.00), as well as ones who started any new concomitant CD treatment later than at least 4 weeks before the start of dietary intervention, were excluded from the analysis. The PCDAI and fecal calprotectin level were assessed at weeks 0 and 12. The primary endpoint was ITT normalization of FCP level, i.e., a result < 250.00 µg/g at week 12. The Wilcoxon Matched Pairs Test was used for statistical analysis. (3) Results: The normalization of the FCP level was obtained in 17 children (35.42%) and an FCP level decrease of at least 50% occurred in 26 patients (54.17%). The reduction in fecal calprotectin level between week 0 and week 12 was statistically significant with a median value of 1045.00 µg/g; IQR = 1188.00, and 363.00 µg/g; IQR = 665.00, respectively (p < 0.05). Among 29 patients who were not in clinical remission at baseline, 16 (55.17%) achieved clinical remission (PCDAI < 10.00) at week 12 and 20 (68.97%) obtained a clinical response defined as at least a 12.50 point drop in PCDAI or remission. In this group, the reduction in PCDAI between baseline and week 12 was statistically significant (median value = 20.00 points; IQR = 7.50 and 5.00 points; IQR = 5.00, respectively (p < 0.05)). All patients with a normal FCP level at week 12 were in clinical remission and 16 (94.13%) of them had a normal CRP (C-reactive protein) value. In 10 children (20.83%) the full course of 12 weeks with CDED + PEN was not completed or the concomitant therapy had been started before week 12 due to the lack of efficacy/intolerance of nutritional treatment. (4) Conclusions: The 12-week course of treatment with the CDED + PEN has a beneficial effect on the fecal calprotectin level in children with active CD. The dietary intervention led to a significant decrease in the FCP level in the studied group and to the normalization of this parameter in every third patient.
Problems with intimacy and sexuality are one of the major concerns of patients with inflammatory bowel diseases (IBD). Many symptoms, complications, and consequences of these disorders are likely to impact on body image, intimacy, and sexual function. Moreover, mood disorders, in particular depression, which is a major risk factor for sexual dysfunctions, are reported to be common in chronic illnesses such as IBD. However, despite this obvious relevance, sexual problems are rarely addressed in the clinical management of patients with IBD. The aim of this review was to discuss sexual problem in people with IBD.
Background The CDED + PEN (partial enteral nutrition) is a promising method of nutritional treatment in active Crohn’s disease (CD). An increase of fecal calprotectin (FCP) level - a marker of mucosal inflammation – happens to be the first evidence of the Crohn’s disease exacerbation, ahead of clinical symptoms, and usually accompanies clinical symptoms. In this study we present our own experience with using the CDED + PEN in treatment of children with CD and higher FCP level. Methods Forty eight children (male/female: 27/21) in age 4–18 years (median value = 13.6; IQR=3.7) were treated with CDED + PEN. The main inclusion criteria to the study was active CD defined as FCP level ≥ 250 µg/g. Patients with severe clinical manifestation of CD (PCDAI >40) or who started any new concomitant CD’s treatment together with the dietary intervention were excluded from the analysis. The PCDAI and fecal calprotectin level were assessed at week 0 and 12. The primary endpoint was ITT normalization of FCP level that is result< 250 µg/g at week 12. Wilcoxon Matched Pairs Test was used for statistical analysis. Results The normalization of FCP level was obtained in 35 % (17) of children and the minimum 50% decrease of FCP level in 56% (27). The reduction of fecal calprotectin level between week 0 and week 12 was statistically significant with median value = 1045 µg/g; IQR=1188 and 363 µg/g; IQR=665, respectively (p<0.05). In the group of 29 patients who were not in clinical remission (PCDAI≥10) at baseline 16 (55%) obtained clinical remission (PCDAI<10) at week 12 and 20 (69%) clinical response defined as a drop in PCDAI of at least 12.5 points or PCDAI<10 points. The reduction of PCDAI between baseline and week 12 was statistically significant (median value = 20 points; IQR=7.5 and 5 points; IQR=6.2, respectively (p<0.05)). All patients with normal FCP level at week 12 were in clinical remission. In 10 children (21%) the full course of 12 weeks with CDED+PEN was not completed or the concomitant therapy had been started before week 12 due to the lack of efficacy/ intolerance of nutritional treatment. Conclusion The 12-weeks course of treatment with the CDED + PEN has a beneficial effect on the fecal calprotectin level in children with active CD. Dietary intervention leaded to significant decrease in the FCP level in studied group and to the normalization of this parameter in every third patient.
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