Effect of Exclusive Enteral Nutrition on Health‐Related Quality of Life for Adults With Active Crohn's Disease

Guo, Zhen; Wu, Rong; Zhu, Weiming; Gong, Jianfeng; Zhang, Wei; Li, Yang; Gu, Lili; Li, Jieshou

doi:10.1177/0884533613487218

Cited by 41 publications

(49 citation statements)

References 31 publications

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“…The lack of difference between the PEN and EEN treatments may be due to the use of 2 weeks of EEN prior to the reintroduction of usual food. During the first 2 weeks of EEN, patients had significant improvements in disease activity and inflammatory markers, such early improvements have been observed previously in the adult EEN literature [13,26,27]. Further, there is some evidence that patients with newly diagnosed disease respond better to nutrition therapy than patients with long-standing intestinal inflammation [28].…”

Section: Discussionmentioning

confidence: 54%

“…EEN is now commonly used to treat active CD in children and adolescents in New Zealand (NZ) [6], Australia [7], Asia [8], Canada [9] and Europe [10]. Adults with CD are interested in nutrition-based alternatives to corticosteroids [11], and EEN is regularly used in Japan [12], and increasingly in China [13] to treat adults with active CD. For adults living in Western countries, EEN is not currently recommended as a first-line treatment for active CD [2,14].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Active Crohn’s Disease with Exclusive and Partial Enteral Nutrition: A Pilot Study in Adults

2017

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Background and Aim: Enteral nutrition (EN) is not commonly used for the treatment of adults with active Crohn’s disease (CD), despite patient interest in nutrition-based alternatives to corticosteroids and evidence of efficacy in paediatric CD. The aim of this study was to assess the impact of 2 different EN regimens on disease symptoms, nutrition and inflammatory markers in young adults with active CD. Methods: A prospective non-randomized pilot study of adults aged 16–40 years with active CD on endoscopy or imaging was undertaken. Patients were sequentially recruited to use 2 weeks of exclusive EN (EEN) followed by either 6 weeks of EEN or partial EN (PEN) with usual diet. Assessments of disease symptoms, nutrition and inflammatory markers were undertaken at baseline and throughout the treatment. Results: Thirty-eight patients with active disease were recruited. Thirty-two (84%) patients completed 2 weeks of EEN and had significant improvements in disease symptoms (p = 0.003), serum c-reactive protein (CRP; p = 0.005), insulin-like growth factor-1 (p = 0.006) and faecal calprotectin (FC; p = 0.028). During the following 6 weeks, 21 patients continued EEN (14 [67%] completed treatment) and 11 patients used PEN (9 [82%] completed treatment). Initial improvements in symptoms, CRP and nutrition markers were sustained over the next 6 weeks on both treatments. FC non-significantly increased in 5 out of 9 patients who used PEN and at week 8 FC was greater than 500 µg/g in 9 out of 14 and 7 out of 9 patients who used exclusive or PEN respectively. There was no significant difference in clinical outcomes between the 2 groups at week 8. Conclusion: Two weeks of EEN significantly improved disease symptoms, nutrition and inflammatory markers. Further treatment with exclusive or PEN maintained initial improvements.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Treatment of Active Crohn’s Disease with Exclusive and Partial Enteral Nutrition: A Pilot Study in Adults

2017

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“…This may explain why patient quality of life has been found to improve post EEN [5,24] even in those using nasogastric tube feeding [23e25]. It should be noted that quality of life post treatment is associated with disease activity [24,25] therefore patients who do not achieve disease remission with EEN usually do not have as large improvements as those who achieve remission.…”

Section: Discussionmentioning

confidence: 95%

Polymeric formula is more palatable than elemental formula to adults with Crohn's disease

2014

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“…Exclusive EN to induce disease remission has been associated with improved HRQOL in children [19, 29] and Chinese adults with CD [30], but its impact on HRQOL has not been reported in adults in western countries. A pediatric study found that children who used steroids have a slightly higher QOL score than children who used EEN to induce remission [29].…”

Section: Discussionmentioning

confidence: 99%

Newly Diagnosed Crohn’s Disease Treated with Standard Care or Enteral Nutrition: Psychological Outcomes over 6 Months

et al. 2019

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Background and Aim: Impaired health-related quality of life and higher rates of anxiety and depression are observed in patients with Crohn’s disease. This single center study aimed to describe and compare longitudinal psychological outcomes of newly diagnosed Crohn’s disease patients treated with standard care or enteral nutrition to induce remission. Methods:Two separate cohorts of patients were recruited from one center and treated with standard care (n = 22) or enteral nutrition (n = 18) to induce disease remission. Disease activity, quality of life, anxiety, and depression were assessed at diagnosis and month 6. Results:At baseline, quality of life (n = 40) was not correlated with disease activity; symptoms of anxiety and depression were present in 15 (38%) and 5 (13%) of the 40 patients, respectively. Significant improvements in quality of life (p <0.0001) and anxiety scores (p = 0.002) were observed after 2 weeks of exclusive enteral nutrition, and at month 6 significant improvements in all psychological outcomes were observed. At month 6, patients who received standard care had a significant improvement in quality of life (p = 0.004), but not in anxiety or depression scores, and there were no differences in psychological outcomes between the treatment groups. Overall, 34/40 (85%) patients were in clinical remission at month 6, and a clinically significant quality of life score was achieved by 31/40 (78%). Conclusions:Patient health-related quality of life and symptoms of anxiety and depression improved as disease activity improved, and 6 months after diagnosis psychological outcomes were similar in patients treated with standard care or enteral nutrition to initially induce remission.

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Effect of Exclusive Enteral Nutrition on Health‐Related Quality of Life for Adults With Active Crohn's Disease

Abstract: A 4-week treatment of EEN improves health-related quality of life significantly in adults with active Crohn's disease and was acceptable by most patients.

Cited by 41 publications

References 31 publications

Treatment of Active Crohn’s Disease with Exclusive and Partial Enteral Nutrition: A Pilot Study in Adults

Treatment of Active Crohn’s Disease with Exclusive and Partial Enteral Nutrition: A Pilot Study in Adults

Polymeric formula is more palatable than elemental formula to adults with Crohn's disease

Newly Diagnosed Crohn’s Disease Treated with Standard Care or Enteral Nutrition: Psychological Outcomes over 6 Months

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