Global attitudes on and the status of enteral nutrition therapy for pediatric inflammatory bowel disease

Abstract

Enteral nutrition (EN) is a diet-remission therapy for inflammatory bowel disease (IBD) that plays a more important role in children than adults. EN includes exclusive enteral nutrition (EEN), partial enteral nutrition (PEN), and maintenance enteral nutrition (MEN). However, EEN remains an unstandardized treatment for pediatric IBD. The types and methods of EN differ around the world. The current study reviewed the EN literature on children with IBD. A total of 12 survey studies were identified that analyzed the current state of EN use, including clinical opinions, implementation methods, treatment course, EEN formula, IBD classification, progress, dietary reintroduction, and patient feedback. The findings revealed that EEN has a strong effect on mild to moderate Crohn’s disease (CD). The usage rates of this treatment in different sites were ileum/colon (Paris classification L3) > ileum (L1) > upper digestive tract (L4) > colon (L2) > perianal disease (P) > ulcerative colitis (UC) > extraintestinal lesions. The polymeric formula was the most used EN formulation. New EN diets include a CD exclusion diet (CDED), a specific carbohydrate diet (SCD), and a CD treatment-with-eating (CD-TREAT) diet. Children with IBD responded similarly to EEN administered orally or using a feeding tube. Most guidelines recommended 6–8 weeks of EEN treatment to induce remission. Many clinicians preferred to combine drug medications during EEN and recommended that MEN accounts for at least 25–35% of daily caloric intake. EN remains an unstandardized therapy that requires teamwork across disciplines.

Pathogenesis and therapy of radiation enteritis with gut microbiota

“…Nutrition therapy is divided into enteral nutrition and parenteral nutrition, both of which have their own characteristics and advantages. Enteral nutrition plays an important role in the recovery of inflammatory bowel disease and is often the first choice of nutritional therapy because it is non-invasive and can help to restore intestinal function (Luo J. et al, 2022). However, parenteral nutrition becomes the first choice when radiation enteritis is accompanied by intestinal obstruction or when fasting is required before surgery (Hellerman Itzhaki and Singer, 2020).…”

The Bidirectional Link between Nutritional Factors and Inflammatory Bowel Diseases: Dietary Deficits, Habits, and Recommended Interventions—A Narrative Review

“…Enteral nutrition is based on elemental (amino acid-based), semi-elemental (oligopeptides) and polymeric (whole protein-based) formulas that can be administered to IBD patients as a complete meal replacement (exclusive enteral nutrition) or in addition to standard meals (partial enteral nutrition). Its efficacy in inducing and maintaining remission has been supported by clinical trials and meta-analyses, despite the heterogeneity of treatment protocols [126]. One explanation for enteral nutrition efficacy is that the polymeric formulation could minimize antigen exposure in the gut resulting from food ingestion [127]; however, whether administered via nasogastric tube or ingested directly, enteral nutrition diets are often poorly tolerated by patients and can be used only for short periods of time.…”