Effect of Exclusive Enteral Nutrition on the Disease Process, Nutrition Status, and Gastrointestinal Microbiota for Chinese Children With Crohn's Disease

Abstract

Background:The aim of this study was to prospectively study the effect of exclusive enteral nutrition (EEN) treatment on Chinese pediatric Crohn's disease (CD) patients. Methods: Thirty-one newly diagnosed CD patients were enrolled in this study and treated with EEN for 8 weeks. Twelve healthy controls (HCs) donated their fecal samples. Statistical methods were used to compare the differences. Results: According to the Simple Endoscopic Score for CD (SES-CD) at the end of the EEN treatment, 21 patients with SES-CD ≤4 were classified into the remission group (CD-RE), and 10 patients with SES-CD >4 were classified into the nonremission group (CD-NRE). After EEN therapy, there was a significant decrease in the SES-CD, the weighted Pediatric Crohn's Disease Activity Index (wPCDAI), and fecal calprotectin (FCP) in the CD-RE group (all P < .001). The wPCDAI and FCP also decreased in the CD-NRE group (both P < .05). In terms of nutrition improvement, the CD-RE group patients showed more improvement in weight gain, hemoglobin, and serum albumin level than the CD-NRE group patients (all P < .05). For the microbiota, the CD patients had a lower bacterial diversity and different bacterial community compared with HCs. EEN increased overall diversity and was able to shift the dysbiosis in CD patients toward a healthier state. Absence of improvement in wPCDAI and Shannon index at 2 weeks predicts poor response at the end of EEN. Conclusion: EEN can be used in most Chinese pediatric CD patients to induce remission and improve nutrition.

Analysis of Risk Factors and Nursing Intervention Measures Affecting Nutritional Status of Children with Crohn’s Disease

“…Therefore, it is necessary to infuse the nutrient solution evenly and in time and secure catheter properly. Parenteral nutrition requires regular pulse pressing flushing and strict aseptic operation principles [ 19 ].…”

Exclusive enteral nutrition: An optimal care pathway for use in children with active luminal Crohn's disease

“…Children responding to EEN have a statistically significant improvement in weight and body mass index z ‐scores over the course of therapy, 4,5 which are sustained over a 6‐month period 4 . In a Chinese study, children who reached remission after an 8‐week course of EEN had statistically significant improvement in weight gain, haemoglobin and serum albumin level, compared with children who did not reach remission on EEN ( P < 0.05) 22 …”

“…Four studies identified a significantly higher rate of mucosal healing in children who received EEN as induction therapy, compared to CS 18,20,21,22 …”

Exclusive Enteral Nutrition Promotes Clinical Remission and Mucosal Healing of Southern China Pediatric Crohn’s Disease in Short Time

“…However, there are very few studies provided information on mucosal healing of patients at the end of induction. Several studies in western countries have found that EEN can induce early mucosal healing rate of 18.9%-58% (3,14).…”