P700 Perceptions towards established and emerging dietary therapies for Crohn’s disease management among the adult patients: results from a questionnaire survey

Abstract

Background Exclusive enteral nutrition (EEN) and partial enteral nutrition (PEN), replacing at least 50% of the energy intake with formula, remain the only evidence-based dietary therapies in the management of Crohn’s disease (CD). Nonetheless, emerging solid food-based dietary therapies are being researched to offer equally effective, but more palatable alternatives. We assessed the perceptions of adults with CD towards EEN, 50% PEN, and novel dietary therapies within a cross-sectional questionnaire survey. Methods The 26-question anonymous survey with a pre-paid return envelope was mailed to 300 adult patients with CD treated with biologics under the care of the NHS Greater Glasgow & Clyde. A reminder was resent three months later. Responses to open-ended questions regarding concerns about 50% PEN use were analysed independently by two researchers using thematic analysis. Results One-hundred and sixty patients (85/160, 53% female) completed and returned the survey (response rate: 53%). Forty-two percent (67/158) had already followed some form of an exclusion diet, with low spice (32/158, 20%) and low fibre (24/158, 15%) diets being the most popular. Although only a quarter of patients believed that EEN or PEN could help with their CD (42/157, 27%), the majority believed that diet could help (84/157, 54%), with another 13% (21/157) reporting already using diet for CD management. Although only around half of the patients were willing to try EEN (80/157, 51%), the majority were willing to try PEN instead (124/157, 79%) (EEN vs. PEN chi-square: P<.001). Most patients preferred to follow an exclusion diet meal plan to prepare at home (65/154, 42%) compared to EEN or PEN (53/153, 34%). Similarly, most patients preferred to follow a meal plan to prepare at home (76/151, 50%) rather than a meal plan with pre-made meals delivered (59/151, 39%). When asked about preferences related to PEN use, most patients reported that they would prefer to follow a flexible meal plan, allowing them to choose meals to replace to fit their lifestyle (92/153, 60%). The most commonly reported concerns about PEN identified within the thematic analysis were taste/palatability (25%, 34/136), satiety/hunger (22%, 30/136), taste fatigue (14%, 19/136), and impact on social life (14%, 19/136). Conclusion Most adult patients would prefer to follow an exclusion diet meal plan rather than EEN or 50% PEN. However, the majority would try 50% PEN which allows for more flexibility and may be easier to comply with than EEN.