Nutritional support in paediatric Crohn's disease: outcome at 12 months

Abstract

BMI Z-score increased but height Z-score remained unchanged over 12 months for the MEN group. Use of MEN was not associated with prolonged time to relapse. Prospective studies are required to examine the utility of MEN.

Exclusive enteral nutrition: An optimal care pathway for use in adult patients with active Crohn's disease

“…The results are conflicting and limited by high dropout rates, different PEN regimens, and lack of control groups . In pediatric and young adult CD cohorts, small studies have reported PEN with an exclusion diet to be effective in remission induction (70%) and maintenance of remission compared to an unrestricted diet (36.4 vs 64% relapse rate, respectively) . Pediatric guidelines do not recommend PEN for induction of remission but highlight its potential role as a maintenance therapy in mild disease .…”

Patient, parent and professional perception of the use of maintenance enteral nutrition in Paediatric Crohn's Disease

“…Maintenance enteral nutrition is also used clinically to maintain weight gain initiated by EEN . However, results from our centre demonstrated there was no difference in BMISDS at twelve months between patients who received MEN and those on normal diet, although clearly in a heterogenous non‐randomised population there are many potential confounders . There is also a paucity of studies on patient tolerance and acceptability of MEN amongst patients.…”

“…Quantitative pooling of the paediatric studies is not feasible due to the diversity of volumes and duration of MEN used. The most recent and largest study of 58 paediatric CD patients by Gavin et al reported no significant difference in length of remission at 12 months between patients receiving MEN compared with normal diet.…”

“…Exclusive Enteral Nutrition (EEN) is widely used to induce remission with continued use of oral nutritional supplements as maintenance enteral nutrition (MEN), given alongside diet to enhance nutritional status and prolong remission . However, the evidence base for MEN prolonging remission in paediatric CD is limited and there is little consensus on the amount or duration of MEN required . There are no randomised controlled trials using MEN versus normal diet to prolong remission in paediatric CD patients, with only a limited number of studies which are non‐randomised, non‐blinded and retrospective (Table ).…”

“…However, the evidence base for MEN prolonging remission in paediatric CD is limited and there is little consensus on the amount or duration of MEN required . There are no randomised controlled trials using MEN versus normal diet to prolong remission in paediatric CD patients, with only a limited number of studies which are non‐randomised, non‐blinded and retrospective (Table ). Quantitative pooling of the paediatric studies is not feasible due to the diversity of volumes and duration of MEN used.…”