Exclusive enteral nutrition for inducing remission in inflammatory bowel disease in paediatric patients

Assa, Amit; Shamir, Raanan

doi:10.1097/mco.0000000000000402

Cited by 13 publications

(15 citation statements)

References 24 publications

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“…EEN administered for 6–8 weeks is as effective as corticosteroid therapy; 5,6 moreover, it improves nutrition status, initiates mucosal healing, and, as such, is recommended as a first‐line treatment in newly diagnosed pediatric patients 7 . Although the mechanism of action of EEN has not been fully elucidated, studies have shown that EEN causes significant changes in the microbiota composition of patients with CD, which may lead to modification of microbial‐based gut inflammation and, consequently, remission of the disease 4,8 . Current evidence supports the notion that CD is associated with community‐level imbalances in gut microbiota rather than the presence or absence of certain bacterial species; 9,10 therefore, community‐level changes could have an influence on disease course.…”

Section: Introductionmentioning

confidence: 96%

“…The best evidence on the efficacy of a dietary intervention in treatment of CD is available for exclusive enteral nutrition (EEN) 4 . EEN administered for 6–8 weeks is as effective as corticosteroid therapy; 5,6 moreover, it improves nutrition status, initiates mucosal healing, and, as such, is recommended as a first‐line treatment in newly diagnosed pediatric patients 7 .…”

Section: Introductionmentioning

confidence: 99%

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Healthy Siblings of Children With Crohn's Disease Exhibit More Rapid Changes in Microbiota Composition as a Response to Exclusive Enteral Nutrition

Sila

Jelić

Trivić

et al. 2020

J Parenter Enteral Nutr

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Background The aim of this study was to determine the impact of exclusive enteral nutrition (EEN) on the microbiota composition of the newly diagnosed Crohn's disease (CD) patients and to determine the effect of EEN received for 2 days in siblings of patients with CD. Methods Newly diagnosed pediatric CD patients (n = 17) and unaffected healthy siblings (n = 10) participated in the study. In CD patients, stool samples were collected at 3 time points: prior to therapy introduction, the second day of EEN therapy, and the last day of EEN therapy. In healthy siblings, stool samples were collected before the introduction of EEN and the second day of EEN. Molecular approach targeting 16S ribosomal RNA was used for analyzing the gut microbiota of participants’ stool samples. Results There was no significant difference in microbial diversity between children with CD and healthy siblings before EEN (P = .127 for HhaI digestion; P = .604 for MspI digestion) as opposed to the second day of EEN (P = .006 HhaI digestion; P = .023 MspI digestion). In healthy controls, significant changes in microbiota composition were apparent by the second day of EEN, contrary to children with CD, in whom similar changes in microbiota composition were apparent on the last day of EEN. Conclusion EEN leads to significant microbiota changes in both healthy children and children with CD. Changes in microbiota composition occur more rapidly in healthy children, whereas in children with CD, significant changes were detected at the end of EEN.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Healthy Siblings of Children With Crohn's Disease Exhibit More Rapid Changes in Microbiota Composition as a Response to Exclusive Enteral Nutrition

Sila

Jelić

Trivić

et al. 2020

J Parenter Enteral Nutr

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“…E.E.N. is currently the primary induction treatment in paediatric CD; partly because steroid therapy has adverse effects and growth has to be maintained in children [5,6]. Since nutrition is expected to play a role in the pathophysiology of IBD, effectiveness of several other (partial) whole food diets in IBD were studied in order to know which foods to include or avoid.…”

Section: Introductionmentioning

confidence: 99%

Food and Food Groups in Inflammatory Bowel Disease (IBD): The Design of the Groningen Anti-Inflammatory Diet (GrAID)

Campmans-Kuijpers

Dijkstra

2021

Nutrients

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Diet plays a pivotal role in the onset and course of inflammatory bowel disease (IBD). Patients are keen to know what to eat to reduce symptoms and flares, but dietary guidelines are lacking. To advice patients, an overview of the current evidence on food (group) level is needed. This narrative review studies the effects of food (groups) on the onset and course of IBD and if not available the effects in healthy subjects or animal and in vitro IBD models. Based on this evidence the Groningen anti-inflammatory diet (GrAID) was designed and compared on food (group) level to other existing IBD diets. Although on several foods conflicting results were found, this review provides patients a good overview. Based on this evidence, the GrAID consists of lean meat, eggs, fish, plain dairy (such as milk, yoghurt, kefir and hard cheeses), fruit, vegetables, legumes, wheat, coffee, tea and honey. Red meat, other dairy products and sugar should be limited. Canned and processed foods, alcohol and sweetened beverages should be avoided. This comprehensive review focuses on anti-inflammatory properties of foods providing IBD patients with the best evidence on which foods they should eat or avoid to reduce flares. This was used to design the GrAID.

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“…Finally, low fat dairy products are added to the diet on the fifteenth day, and gradually patients can use a regular diet as tolerated. For maintenance, patients can use EEN in one out of every 4 months in the year or be fed nocturnal partial enteral nutrition (PEN) for 4-5 days every week (3,5).…”

mentioning

confidence: 99%

“…The mechanism of action in EEN treatment of CD has not yet been fully elucidated, however, the probable mechanisms includes low allergen load, absence of food additives, being nucleotide free, and an anti-inflammatory lipid composition. Recently, it has been hypothesized that EEN has a specific effect on the intestinal microbiome, positively interfering with the dysbiosis in CD patients (3,5,7). Further studies are needed to evaluate the exact mechanism of action of this treatment.…”

mentioning

confidence: 99%

Diet-Therapy in Pediatric Crohn’s Disease: A New Approach

Hekmatdoost

2018

Nutr Food Sci Res

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Exclusive enteral nutrition for inducing remission in inflammatory bowel disease in paediatric patients

Cited by 13 publications

References 24 publications

Healthy Siblings of Children With Crohn's Disease Exhibit More Rapid Changes in Microbiota Composition as a Response to Exclusive Enteral Nutrition

Healthy Siblings of Children With Crohn's Disease Exhibit More Rapid Changes in Microbiota Composition as a Response to Exclusive Enteral Nutrition

Food and Food Groups in Inflammatory Bowel Disease (IBD): The Design of the Groningen Anti-Inflammatory Diet (GrAID)

Diet-Therapy in Pediatric Crohn’s Disease: A New Approach

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