Repeated exclusive enteral nutrition in the treatment of paediatric Crohn's disease: predictors of efficacy and outcome

Frivolt, Klára; Schwerd, Tobias; Werkstetter, Katharina; Schwarzer, A.; Schatz, Stephanie Barbara; Bufler, Philip; Koletzko, Sibylle

doi:10.1111/apt.12770

Cited by 72 publications

(76 citation statements)

References 29 publications

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“…In the current study we observed that 80% of the patients were in clinical remission at week 12. This corroborates previous findings observed with this type of intervention [2,13,14].…”

Section: Discussionsupporting

confidence: 93%

“…The efficacy of EEN in the pediatric CD population is well established [2,4,12]. In this study the standard of care, which consists of EEN as the sole source of nutrition for up to 8 weeks, was provided.…”

Section: Discussionmentioning

confidence: 99%

“…The pediatric CD population represents a particularly challenging group of IBD patients, as, in addition to an extended course of disease, growth failure and malnutrition are some of its major complications. Exclusive enteral nutrition (EEN) forms one of the mainstays of the different therapeutic approaches in this population has been recommended as the first choice of treatment with a high remission rate, particularly in newly diagnosed patients [2,3]. Apart from avoiding the metabolic consequences of systemic corticosteroids, the benefits of nutritional therapy include: a) improved mucosal healing; b) improved quality of life; c) improvement in nutritional status and; d) improvement in musculoskeletal growth parameters [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Characterization of Selected Metabolic and Immunologic Markers Following Exclusive Enteral Nutrition of Pediatric Crohn’s Disease Patients

Brahmbhatt¹,

Montoliu²

2016

J Gastrointest Dig Syst

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Objectives: Exclusive enteral nutrition (EEN) is one of the first-line therapeutic options for pediatric patients with active Crohn's disease (CD). However, only sparse data exist on plasma metabolic changes from patients on EEN therapy. Thus to gain mechanistic insights, we have characterized selected markers in pediatric CD patients treated with EEN for induction of disease remission.Methods: Plasma levels of 18 cytokines and chemokines and 163 metabolites in 10 pediatric CD patients receiving 8 weeks of EEN therapy were measured. Measurements were performed at three time points: a) at baseline (V0); b) during EEN intervention at week 4 (V4) and; c) at 4 weeks after completion of EEN therapy at week 12 (V12). Results:Comparisons between V0 and V4 levels identified changes in 20 different molecules, including increases in 7 metabolites of the diacyl phosphatidylcholine (PC) class and 6 metabolites of the alkylacyl PC class. However, most of these changes were not sustained after returning to a normal diet, i.e. only 7 out of the 20 molecules with significant changes between V0 and V4 still retained significance upon comparing V0 and V12. Conclusions:The changes in the plasma levels of various phospholipids at different time-points reflect the nutritional intervention and improved health status of pediatric CD patients.

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“…In the current study we observed that 80% of the patients were in clinical remission at week 12. This corroborates previous findings observed with this type of intervention [2,13,14].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characterization of Selected Metabolic and Immunologic Markers Following Exclusive Enteral Nutrition of Pediatric Crohn’s Disease Patients

Brahmbhatt¹,

Montoliu²

2016

J Gastrointest Dig Syst

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show abstract

“…88 In some studies, early EEN is effective in inducing clinical, biochemical, and mucosal remission and improves outcomes at 1 year. [89][90][91] Although EEN has been successfully used and proven to be highly effective, it is often not preferred by patients due to the difficulty involved in administration. It may require tube feeding and typically consists of no food for 6 weeks.…”

Section: Dietary Recommendationsmentioning

confidence: 99%

Health Care Maintenance for the Pediatric Patient With Inflammatory Bowel Disease

DeFilippis

Barfield

2016

Pediatrics

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Nearly one-quarter of patients with inflammatory bowel disease (IBD) are younger than 20 years of age at diagnosis. Furthermore, the incidence of IBD in children continues to increase. Nevertheless, variation in management exists within the care of patients with IBD with regards to disease screening and preventive care. A multidisciplinary approach that involves the general practitioner and pediatric gastroenterologist is needed to routinely monitor growth, bone health, vitamin and mineral deficiencies, vaccination status, and endoscopic surveillance. It is also important to monitor for extraintestinal manifestations of IBD that may affect the liver, joints, skin, and eyes. The purpose of this article is to provide an updated overview of comprehensive care for pediatric patients with IBD.

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“…The restrictive nature of EEN is difficult to maintain while targeted food elimination may be more sustainable. That genetic polymorphisms in the NOD2 gene are associated with differential outcomes in children with Crohn's disease treated with EEN supports the concept that individualization of dietary therapeutic approaches can improve outcomes [10].…”

mentioning

confidence: 72%

Individualized Food-Based Dietary Therapy for Crohn’s Disease: Are We Making Progress?

Lee

Suskind

2016

Dig Dis Sci

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Repeated exclusive enteral nutrition in the treatment of paediatric Crohn's disease: predictors of efficacy and outcome

Abstract: SUMMARY BackgroundExclusive enteral nutrition (EEN) induces remission and mucosal healing in children with active Crohn's disease (CD).

Cited by 72 publications

References 29 publications

Characterization of Selected Metabolic and Immunologic Markers Following Exclusive Enteral Nutrition of Pediatric Crohn’s Disease Patients

Characterization of Selected Metabolic and Immunologic Markers Following Exclusive Enteral Nutrition of Pediatric Crohn’s Disease Patients

Health Care Maintenance for the Pediatric Patient With Inflammatory Bowel Disease

Individualized Food-Based Dietary Therapy for Crohn’s Disease: Are We Making Progress?

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