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Aliment Pharmacol Ther. 2009 Sep 1;30(5):501-7. doi: 10.1111/j.1365-2036.2009.04067.x. Epub 2009 Jun 15.

The use of exclusive enteral nutrition for induction of remission in children with Crohn's disease demonstrates that disease phenotype does not influence clinical remission.

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1
Department of Nutrition and Dietetics, Yorkhill Hospital, Glasgow, UK.

Abstract

BACKGROUND:

Exclusive enteral nutrition (EEN) achieves variable remission rates in patients with Crohn's disease (CD).

AIM:

To describe our experience of treating CD with an 8-week course of primary EEN and to study factors affecting treatment outcome.

METHODS:

All CD patients treated with EEN in our centre between 2004 and 2007 were included in the study. Remission was determined by a combination of clinical parameters. Disease phenotype was assigned using published classifications. Inflammatory markers and anthropometry (Z-scores) were calculated before and after treatment.

RESULTS:

A total of 114 children were treated (four were excluded). Median age at diagnosis was 11.6 years. Fifty-seven (51.8%) were fed orally whilst 53 (48.2%) were fed by tube. Eighty-eight (80%) achieved remission with consequent reductions in erythrocyte sedimentation rate and C-reactive protein (P < 0.001). Patients in remission had comparative improvements in weight (-1.04 cf. -0.40) and BMI Z-scores (-0.98 cf. -0.03) by the end of treatment (P < 0.001). Individuals with isolated terminal ileal disease (n = 4) had lower remission rates than other locations (P = 0.02). No other significant differences in remission rates for any other disease locations were found.

CONCLUSIONS:

Exclusive enteral nutrition induces clinical remission, normalization of inflammatory markers and improves weight/BMI Z-scores in most patients. This study demonstrates that disease phenotype should not influence clinicians when commencing patients on EEN.

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