Comparing Effectiveness of a Generic Oral Nutritional Supplement With Specialized Formula in the Treatment of Active Pediatric Crohn’s Disease

Dawson, R; Wands, David; Logan, Michael; Bremner, Gillian; Efklides, S; Benn, Laura; Henderson, Paul; Grant, Hugh W.; Meredith, Joseph; Armstrong, K; Wilson, David C.; Gerasimidis, Konstantinos; Alex, George; Russell, Richard K.

doi:10.1093/ibd/izac039

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…, Several studies have recently been published which expanded our knowledge on the use of EEN in the management of paediatric CD (Table 1). In a retrospective study, there were no differences in clinical remission rates, improvement of anthropometry indices or inflammatory biomarkers between an CD specific enteral nutrition formula and a generic oral nutritional supplement [5].…”

Section: Exclusive Enteral Nutrition In the Management Of Paediatric ...mentioning

confidence: 89%

An update on dietary therapies in paediatric Crohn's disease

Gkikas,

Svolos,

White

et al. 2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review This article provides a literature update on original articles published in the past 18 months (May 2022–November 2023) in the dietary management of paediatric Crohn's disease. Recent findings There is more data to support the use of exclusive enteral nutrition in the management of active Crohn's disease in children. Several food-based dietary therapies have been proposed for the management of Crohn's disease. There is an interest in precision nutritional therapy in Crohn's disease, but current data are scarce. Summary Exclusive enteral nutrition is an effective treatment for paediatric Crohn's disease. Predictors of response to exclusive enteral nutrition include mild disease phenotype and ileal disease involvement, although data remain inconclusive. Adherence to exclusive enteral nutrition is cornerstone to its efficacy. Treatment with exclusive enteral nutrition modifies the gut microbiome, modulates bile acid metabolism and has significant effects on host immune responses. More studies are expected in which drugs need to be combined with dietary therapies and microbial therapeutics. The efficacy of Crohn's disease exclusion diet coupled with partial enteral nutrition is supported by independent studies, but tolerance remains an issue, particularly for long-term disease management. More research is anticipated in precision nutritional therapy in paediatric Crohn's disease, but currently no recommendations can be made.

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Section: Exclusive Enteral Nutrition In the Management Of Paediatric ...mentioning

confidence: 89%

An update on dietary therapies in paediatric Crohn's disease

Gkikas,

Svolos,

White

et al. 2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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show abstract

“…The composition of formulas used as EEN varies greatly [ 30 ]. To date, no formula has shown any benefits over any other formula in inducing clinical remission in CD [ 31 , 32 ]. A compositional analysis on 61 formulas successfully used as EEN to induce remission in active CD, as compared to dietary intake of children with longstanding CD, revealed that formulas used as EEN generally contained lower sugar, total fat, saturated fat, and fiber content, and a higher percentage of protein [ 30 ].…”

Section: Exclusive Enteral Nutritionmentioning

confidence: 99%

Current Nutritional Therapies in Inflammatory Bowel Disease: Improving Clinical Remission Rates and Sustainability of Long-Term Dietary Therapies

Reznikov

Suskind

2023

Nutrients

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Inflammatory Bowel Disease (IBD) includes a spectrum of chronic immune-mediated intestinal diseases thought to be related to the complex interaction between the host immune system and the intestinal microbiome. Research supports the use of nutritional therapy in IBD; however, it is not routinely used in clinical practice. This literature review seeks to advance the understanding of diet and its effect in IBD with a focus on both Crohn’s Disease (CD) and Ulcerative Colitis (UC). The contribution of diet to the development and treatment of IBD cannot be overstated. In both pediatric as well as adult IBD, nutritional interventions have been shown to improve clinical symptoms as well as inflammatory burden. The impact of dietary intervention is best exemplified through the use of Exclusive Enteral Nutrition (EEN) in CD. EEN and clinical research on exclusionary whole food diets—Crohn’s Disease Exclusion Diet (CDED), Specific Carbohydrate Diet (SCD), low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet, and Mediterranean Diet—are discussed within this review. Current clinical literature supports the elimination of detrimental components and the incorporation of low processed whole foods in the diet. Additional prospective and longitudinal dietary studies on sustainable and long-term dietary options, along with a deeper understanding of the mechanism, are needed to further advance the role of nutritional interventions in IBD.

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Nationwide Real-World Exclusive Enteral Nutrition Practice Over Time: Persistence of Use as Induction for Pediatric Crohn’s Disease and Emerging Combination Strategy With Biologics

Wands,

Gianolio,

Wilson

et al. 2023

Inflammatory Bowel Diseases

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Background Exclusive enteral nutrition (EEN) is the recommended first-line induction treatment in pediatric patients with active luminal Crohn’s disease (CD). We aimed to provide a nationwide overview of evolving EEN practices during an era of increasing biologic use. Methods We analyzed a prospectively identified nationwide cohort of newly diagnosed pediatric patients with CD in Scotland between January 1, 2015, and June 30, 2022. Patients who received EEN for any indication were divided into 6-monthly epochs and examined over time. Differences during the COVID-19 pandemic (March 16, 2020, to July 19, 2021) were examined. Data were retrospectively collected from electronic medical records: demographics, anthropometrics, concomitant treatments, aspects of EEN administration, and remission/response rates. Descriptive statistics and linear regression were used for analyses. Results A total of 649 patients with CD were identified (63% male; median age 12.6 [interquartile range, 10.8-14.8] years); 497 (77%) of 649 received EEN as postdiagnosis induction therapy with a median course length of 7.7 (interquartile range, 5.9-8.0) weeks. Including repeat courses, 547 EEN courses were examined. An increasing incidence of CD was observed over time with no significant changes in EEN usage, remission or response rates, nasogastric tube usage, or course completion (all P > .05). Increasing use of EEN combined with biologics (combination induction) as first-line induction was observed over time (P < .001). Considering COVID-19, lower rates of EEN usage were observed (P = .008) with no differences in remission, oral administration, and course completion rates (all P > .05). Conclusions Over the past 7.5 years, except during the COVID-19 pandemic, EEN usage rates have not changed despite an increase in biologic use, although combination induction is an emerging trend.

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Comparing Effectiveness of a Generic Oral Nutritional Supplement With Specialized Formula in the Treatment of Active Pediatric Crohn’s Disease

Cited by 3 publications

References 16 publications

An update on dietary therapies in paediatric Crohn's disease

An update on dietary therapies in paediatric Crohn's disease

Current Nutritional Therapies in Inflammatory Bowel Disease: Improving Clinical Remission Rates and Sustainability of Long-Term Dietary Therapies

Nationwide Real-World Exclusive Enteral Nutrition Practice Over Time: Persistence of Use as Induction for Pediatric Crohn’s Disease and Emerging Combination Strategy With Biologics

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