Enteral Nutrition and Corticosteroids in the Treatment of Acute Crohn's Disease in Children

Abstract

There is no difference in efficacy between enteral nutrition and corticosteroid therapy in the treatment of acute Crohn's disease in children. Improved growth and development, without the side effects of steroid therapy, make enteral nutrition a better choice for first-line therapy in children with active Crohn's disease.

Letter: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease—Authors’ reply

“…In fact, our results are consistent with other systematic reviews that focused solely on children, making this the third meta-analysis in the last 17 years to find no difference between exclusive enteral nutrition (EEN) and corticosteroids in the induction of remission in paediatric Crohn's disease [2][3][4] The Zachos study also combined adult and paediatric data and we suggest caution in combining these data sets as EEN may be more effective in paediatric populations. Due to this heterogeneity across age-strata, when conducting a study on the efficaciousness of enteral nutrition, it is imperative to examine children separately from adults in order to avoid the underestimation of the benefit of enteral nutrition.…”

Colitis, independent of macronutrient intake, compromises bone structure and strength in growing piglets

“…Exclusive enteral nutrition has recently been used as the therapy of choice to induce remission in patients with Crohn's disease with about 80% of patients entering remission after 8 weeks (28). Enteral feeds and steroids have similar efficacy in promoting remission (29) and patients receiving nutritional therapy showed less reduction in BMD than those receiving corticosteroids (30). Recently, after eight weeks of exclusive enteral nutrition, markers of bone resorption and bone formation normalized to control levels, suggesting that adequate nutrition or nutritional therapy may normalize bone turnover by reducing inflammation (31).…”

Probable inflammatory bowel disease in a child: assessment and conservative management

“…There has been a significant amount of information regarding dietary therapies for Crohn's disease. Heuschkel et al (12) concluded that dietary therapy is as effective as corticosteroid therapy. In fact they emphasized that, "In view of the benefits of dietary therapy on growth, development, and probably the gut mucosa, an enteral diet should be recommended as a first line therapy in all children with active Crohn's disease."…”

“…In fact they emphasized that, "In view of the benefits of dietary therapy on growth, development, and probably the gut mucosa, an enteral diet should be recommended as a first line therapy in all children with active Crohn's disease." (12) …”