Use of exclusive enteral nutrition in paediatric Crohn's disease in The Netherlands

Bie, Charlotte de; Kindermann, Angelika; Escher, Johanna C.

doi:10.1016/j.crohns.2012.07.001

Cited by 52 publications

(47 citation statements)

References 38 publications

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“…Despite the convincing results regarding immediate benefits of nutritional treatment, duration of remission is poorly studied. In accordance with reports from other centres, [17][18][19] we observed relapses within 1 year in approximately two-thirds of patients following each course of EEN. The high relapse rate occurred in spite of early introduction of immunomodulatory therapy with azathioprine.…”

Section: Discussionsupporting

confidence: 76%

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

Frivolt

Schwerd²,

Werkstetter³

et al. 2014

Aliment Pharmacol Ther

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Section: Discussionsupporting

confidence: 76%

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

Frivolt

Schwerd²,

Werkstetter³

et al. 2014

Aliment Pharmacol Ther

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“…The high proportion of female patients and secondary school age patients is likely to have affected treatment completion. Females and older adolescents are more likely to withdraw from treatment due to non-adherence [10] and this trend was observed in the current study, whereby 73% of adolescents did not complete EN treatment compared with only 26% of young adults aged 18 years and older. EN treatment may be a more acceptable treatment for patients who have finished secondary education and moved into the workforce or tertiary education.…”

Section: Discussionsupporting

confidence: 51%

“…Nutrition-based treatments, the most common being exclusive enteral nutrition (EEN), is recommended as a first-line therapy to treat active paediatric CD [5]. 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.…”

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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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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“…In a prospective study, Grogan et al18 reported that 93% and 79% of patients who received elemental formula and a polymeric diet, respectively, achieved remission after 6 weeks of EEN treatment. Furthermore, de Bie et al19 reported that EEN treatment with hyperosmolar sip feeds or a polymeric diet for 6 weeks resulted in complete remission in 55 of 77 patients (71%); however, EEN was discontinued in 10 of 77 patients (13%) due to nonadherence. The findings of the present study indicate similar efficacy with a shorter EEN treatment duration.…”

Section: Discussionmentioning

confidence: 99%

Japanese physicians' attitudes towards enteral nutrition treatment for pediatric patients with Crohn's disease: a questionnaire survey

et al. 2017

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Background/AimsEnteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices.MethodsTwo types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011.ResultsA total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days.ConclusionsEN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.

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Use of exclusive enteral nutrition in paediatric Crohn's disease in The Netherlands

Cited by 52 publications

References 38 publications

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

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

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

Japanese physicians' attitudes towards enteral nutrition treatment for pediatric patients with Crohn's disease: a questionnaire survey

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