Partial enteral nutrition induces clinical and endoscopic remission in active pediatric Crohn’s disease: results of a prospective cohort study

Urlep, Darja; Benedik, Evgen; Brecelj, Jernej; Orel, Rok

doi:10.1007/s00431-019-03520-7

Cited by 33 publications

(62 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The ESPHGAN guideline recommends a daily caloric intake of at least 50% to reach therapeutic efficacy for effective prolongation of remission in low-risk CD [ 9 ]. Recently, different studies have investigated the role of PEN in combination with specific diets such as CDED and anti-inflammatory diet (AID)-CD, reaching promising results and showing the effectiveness of combination therapy with PEN and other specific diets [ 3 , 97 , 98 , 99 ].…”

Section: Different Types Of Nutritional Therapy and Their Efficacymentioning

confidence: 99%

Nutritional Therapy Strategies in Pediatric Crohn’s Disease

et al. 2021

View full text Add to dashboard Cite

The increase in incidences of pediatric Crohn’s Disease (CD) worldwide has been strongly linked with dietary shifts towards a Westernized diet, ultimately leading to altered gut microbiota and disturbance in intestinal immunity and the metabolome. Multiple clinical studies in children with CD have demonstrated the high efficacy of nutritional therapy with exclusive enteral nutrition (EEN) to induce remission with an excellent safety profile. However, EEN is poorly tolerated, limiting its compliance and clinical application. This has spiked an interest in the development of alternative and better-tolerated nutritional therapy strategies. Several nutritional therapies have now been designed not only to treat the nutritional deficiencies seen in children with active CD but also to correct dysbiosis and reduce intestinal inflammation. In this review, we report the most recent insights regarding nutritional strategies in children with active CD: EEN, partial enteral nutrition (PEN), Crohn’s disease exclusion diet (CDED), and CD treatment-with-eating diet (CD-TREAT). We describe their setup, efficacy, safety, and (dis)advantages as well as some of their potential mechanisms of action and perspectives. A better understanding of different nutritional therapeutic options and their mechanisms will yield better and safer management strategies for children with CD and may address the barriers and limitations of current strategies in children.

show abstract

Section: Different Types Of Nutritional Therapy and Their Efficacymentioning

confidence: 99%

Nutritional Therapy Strategies in Pediatric Crohn’s Disease

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Consistent with previous reports, the subgroup of patients who achieve long-term clinical remission after a single course of nutrition without additional immunomodulation merits consideration [14]. Reducing exposure for this sizeable subgroup to immune suppression will become an essential topic for future study given the emergence of novel oral diet alternatives to EEN [11,15]. The Crohn's Disease Exclusion Diet (CDED) study recently showed that sustained exposure to diet therapy beyond achieving clinical remission at week 6 reduces early relapse (and rise in calprotectin) as occurs in up to 50% of EEN-treated patients [15,16].…”

mentioning

confidence: 54%

“…With comparable rates of early clinical remission to steroids, nutrition (exclusively or partial enteral nutrition with novel exclusion diets) has been shown superior in terms of achieving steroid-free remission, normal Creactive protein (CRP) remission, and mucosal healing in prospective and retrospective studies [8][9][10][11][12]. Although Scarpato et al did not use propensity-score matching, they did show that their historical cohorts of EEN-vs steroid-treated patients did not differ for several features typically included in propensity-score matching.…”

mentioning

confidence: 99%

“…The delay in the approval of new molecules for pediatric IBD-with more than 5 years between approval of biologics in adults to approval for use in children with IBD as a rule, not the exception-and safety concerns about increased immune suppression with infectious, oncologic, or hematologic side effects have triggered pediatric gastroenterologists to consider novel combinations of diet and anti-TNF therapy [2,11,22,23]. Several studies have illustrated that partial EN can improve anti-TNF longevity as well as response to treatment escalation if standard dosing is insufficient in adult CD [24,25].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Fool me once… treatment exposure to achieve remission in pediatric IBD

2020

View full text Add to dashboard Cite

“…It is not suitable to be used as source of nutrition. The dosage recommended is two sachets of 60 g per day in the active phase of CD, and one sachet of 60 g per day as a nutritional support during the remission phase [79].…”

Section: Enteral Formulas Supplemented With Tgf Used In Ibd Patients mentioning

confidence: 99%

Enteral Nutrition Supplemented with Transforming Growth Factor-β, Colostrum, Probiotics, and Other Nutritional Compounds in the Treatment of Patients with Inflammatory Bowel Disease

2020

View full text Add to dashboard Cite

Enteral nutrition seems to play a significant role in the treatment of both adults and children with active Crohn’s disease, and to a lesser degree in the treatment of patients with active ulcerative colitis. The inclusion of some special factors in the enteral nutrition formulas might increase the rate of the efficacy. Actually, enteral nutrition enriched in Transforming Growth Factor-β reduced the activity index and maintained remission in patients with Crohn’s disease. In addition, a number of experimental animal studies have shown that colostrum exerts a significantly positive result. Probiotics of a special type and a certain dosage could also reduce the inflammatory process in patients with active ulcerative colitis. Therefore, the addition of these factors in an enteral nutrition formula might increase its effectiveness. Although the use of these formulas is not supported by large clinical trials, it could be argued that their administration in selected cases as an exclusive diet or in combination with the drugs used in patients with inflammatory bowel disease could benefit the patient. In this review, the authors provide an update on the role of enteral nutrition, supplemented with Transforming Growth Factor-β, colostrum, and probiotics in patients with inflammatory bowel disease.

show abstract

Partial enteral nutrition induces clinical and endoscopic remission in active pediatric Crohn’s disease: results of a prospective cohort study

Cited by 33 publications

References 32 publications

Nutritional Therapy Strategies in Pediatric Crohn’s Disease

Nutritional Therapy Strategies in Pediatric Crohn’s Disease

Fool me once… treatment exposure to achieve remission in pediatric IBD

Enteral Nutrition Supplemented with Transforming Growth Factor-β, Colostrum, Probiotics, and Other Nutritional Compounds in the Treatment of Patients with Inflammatory Bowel Disease

Contact Info

Product

Resources

About