Enteral nutrition for maintenance of remission in Crohn's disease

Akobeng, Anthony K; Zhang, Dongni; Gordon, Morris; MacDonald, John K

doi:10.1002/14651858.cd005984.pub3

Cited by 19 publications

(23 citation statements)

References 49 publications

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“…The decision on the type of formula used may be influenced by evidence from clinical studies, the dietary modulation of the intestinal immune response in IBD, and its potential clinical implications [34]. There is currently insufficient evidence to make firm recommendations about one feed composition over another [35,36]. Therefore, standard polymeric feeds are often utilised due to increased palatability [37,38,39,40].…”

Section: En Formulationsmentioning

confidence: 99%

“…The third is that specific formulations are not recommended and standard EN (polymeric, moderate fat, no particular supplements) can be used for primary or supportive nutritional therapy. This is due to insufficient evidence of statistically significant difference between types of enteral formulae in terms of protein composition (elemental, semi-elemental, oligomeric, polymeric), fat content or addition of growth factors [35,36,62,99,100,101,102]. Lastly, for administration of EN, enteral tube feeding can be by nasal or gastrostomy tubes and continuous enteral feeding via a pump should be used instead of bolus feeding, given the lower complication rates seen in continuous feeding [103,104,105,106,107].…”

Section: Guidelinesmentioning

confidence: 99%

“…A Cochrane review on the use of EN for maintenance of remission in CD included both EEN and PEN and was published in 2018 [35] as an update of the previous review published in 2007 [134]. The aim of the review was also to assess the impact of different formulations on outcomes and their safety profiles.…”

Section: Efficacy Of Een and Pen In Induction And Maintenance Of Rmentioning

confidence: 99%

“…These two randomized controlled trials were analysed in the Cochrane review by Akobeng et al [35], but data analysis was limited by small sample sizes. A systematic review of 10 studies concluded that PEN with polymeric or elemental formulation significantly increased length of remission compared to no PEN [138].…”

Section: Efficacy Of Een and Pen In Induction And Maintenance Of Rmentioning

confidence: 99%

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Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

Fragkos

Keetarut

et al. 2019

Nutrients

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Medical and surgical treatments for Crohn’s disease are associated with toxic effects. Medical therapy aims for mucosal healing and is achievable with biologics, immunosuppressive therapy, and specialised enteral nutrition, but not with corticosteroids. Sustained remission remains a therapeutic challenge. Enteral nutrition, containing macro- and micro-nutrients, is nutritionally complete, and is provided in powder or liquid form. Enteral nutrition is a low-risk and minimally invasive therapy. It is well-established and recommended as first line induction therapy in paediatric Crohn’s disease with remission rates of up to 80%. Other than in Japan, enteral nutrition is not routinely used in the adult population among Western countries, mainly due to unpalatable formulations which lead to poor compliance. This study aims to offer a comprehensive review of available enteral nutrition formulations and the literature supporting the use and mechanisms of action of enteral nutrition in adult Crohn’s disease patients, in order to support clinicians in real world decision-making when offering/accepting treatment. The mechanisms of actions of enteral feed, including their impact on the gut microbiome, were explored. Barriers to the use of enteral nutrition, such as compliance and the route of administration, were considered. All available enteral preparations have been comprehensively described as a practical guide for clinical use. Likewise, guidelines are reported and discussed.

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Section: En Formulationsmentioning

confidence: 99%

Section: Guidelinesmentioning

confidence: 99%

Section: Efficacy Of Een and Pen In Induction And Maintenance Of Rmentioning

confidence: 99%

Section: Efficacy Of Een and Pen In Induction And Maintenance Of Rmentioning

confidence: 99%

See 2 more Smart Citations

Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

Fragkos

Keetarut

et al. 2019

Nutrients

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“…Crohn disease (CD) is a chronic relapsing systemic inflammatory disease afflicting the gastrointestinal system with a high morbidity. [1,2] It is a type of inflammatory bowel disease (IBD) that may involve any portion of the gastrointestinal tract and numerous extraintestinal sites. [3,4] Presenting symptoms are often variable and frequently include abdominal pain, fever, diarrhea with passage of blood or mucous, or both, nausea, vomiting, and weight loss.…”

Section: Introductionmentioning

confidence: 99%

Traditional Chinese medicine for management of recurrent and refractory Crohn disease

Lai

Wang

Dong³

et al. 2019

Medicine

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Introduction: Crohn disease (CD) is a chronic relapsing systemic inflammatory disease afflicting the gastrointestinal system with a high morbidity. There has been increasing clinical interest in traditional Chinese medicine (TCM) treatment for CD. This report aims to present patient outcome of therapeutic management using TCM in combination with pharmacologic therapy. Patient concerns: A 53-year-old woman with a more than 23-year history of chronic indigestion, reflux, abdominal pain, and excessive diarrhea, and a more than 21-year history of recurrent refractory CD. The condition had been managed for 21 years with ongoing pharmacologic therapy, and surgical intervention; however, with poor therapeutic effect. Diagnosis: In this study, the diagnosis of CD was based on integrating patient symptoms and radiologic findings and biopsy results. The patient had no differential diagnosis. Interventions: The patient received acupuncture treatment at an approximate frequency of once per week for a total of 21 sessions until November 5, 2018. The patient also received Chinese herbal medicine (CHM) on an as-needed basis to manage her symptoms. Outcomes: Patient reported symptoms of chronic indigestion, reflux, abdominal pain, and excessive diarrhea were substantially improved by combined TCM and pharmacologic therapy intervention, while the dosage of her medication was reduced. Conclusion: Following acupuncture treatment, improvements of subjective symptoms: chronic indigestion, reflux, abdominal pain, and excessive diarrhea, were observed. CHM provided immediate relief of indigestion, reflux, and abdominal pain. TCM may be a potential therapeutic strategy to manage clinical symptoms of CD, if this is proven useful in future RCT studies.

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Dietary interventions for induction and maintenance of remission in inflammatory bowel disease

Limketkai

Iheozor‐Ejiofor

Gjuladin-Hellon

et al. 2019

Cochrane Database of Systematic Reviews

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105

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Analysis 2.4. Comparison 2 Intervention diet versus control diet in inactive Crohn's disease, Outcome 4 Need for surgery......... Analysis 2.5. Comparison 2 Intervention diet versus control diet in inactive Crohn's disease, Outcome 5 Disease progression...... Analysis 2.6. Comparison 2 Intervention diet versus control diet in inactive Crohn's disease, Outcome 6 Escalation of therapy..... Analysis 2.7. Comparison 2 Intervention diet versus control diet in inactive Crohn's disease, Outcome 7 Withdrawals due to adverse events.

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Enteral nutrition for maintenance of remission in Crohn's disease

Abstract: What did the researchers investigate? Enteral nutrition for maintenance of remission in Crohn's disease (Review)

Cited by 19 publications

References 49 publications

Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

Traditional Chinese medicine for management of recurrent and refractory Crohn disease

Dietary interventions for induction and maintenance of remission in inflammatory bowel disease

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