Patient, parent and professional perception of the use of maintenance enteral nutrition in Paediatric Crohn's Disease

Gavin, J; Marino, Luise V.; Ashton, James J.; Beattie, R Mark

doi:10.1111/apa.14571

Cited by 7 publications

(9 citation statements)

References 26 publications

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“…Although MEN consumption seems a promising strategy for disease maintenance in CD, long-term adherence may be challenging for some patients [ 104 ]. Hence, there is an unmet need to identify the exact dietary components triggering disease activity and develop sustainable, long-term dietary strategies based on the exclusion of these components.…”

Section: Future Directionsmentioning

confidence: 99%

Dietary Strategies for Maintenance of Clinical Remission in Inflammatory Bowel Diseases: Are We There Yet?

et al. 2020

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The etiopathogenesis of Inflammatory bowel disease (IBD) is a result of a complex interaction between host immune response, the gut microbiome and environmental factors, such as diet. Although scientific advances, with the use of biological medications, have revolutionized IBD treatment, the challenge for maintaining clinical remission and delaying clinical relapse is still present. As exclusive enteral nutrition has become a well-established treatment for the induction of remission in pediatric Crohn’s disease, the scientific interest regarding diet in IBD is now focused on the development of follow-on dietary strategies, which aim to suppress colonic inflammation and delay a disease flare. The objective of this review is to present an extensive overview of the dietary strategies, which have been used in the literature to maintain clinical remission in both Crohn’s disease and Ulcerative colitis, and the evidence surrounding the association of dietary components with clinical relapse. We also aim to provide study-related recommendations to be encompassed in future research studies aiming to investigate the role of diet during remission periods in IBD.

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Section: Future Directionsmentioning

confidence: 99%

Dietary Strategies for Maintenance of Clinical Remission in Inflammatory Bowel Diseases: Are We There Yet?

et al. 2020

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“…Gavin et al [91] conduct a survey including patients, parents and UK dietitians regarding their experience with maintenance enteral nutrition (MEN) which is Partial Enteral Nutrition in Crohn's Disease DOI: http://dx.doi.org/10.5772/intechopen.95385 often routinely used in paediatric CD to prolong remission although there is limited evidence for efficacy and a lack of formal guidelines. They identified a different perspective between patients, families and professionals on the use of MEN.…”

Section: Pen For Maintenance Therapy In Paediatric CD Patientsmentioning

confidence: 99%

“…This study advocates that the extensive use of MEN in clinical practice is limited to comply with ESPGHAN recommendations. Patient led care promotes the use of dietary advice as a mode of nutritional support during inactive disease [91].…”

Section: Pen For Maintenance Therapy In Paediatric CD Patientsmentioning

confidence: 99%

Partial Enteral Nutrition in Crohn’s Disease

Benedik¹,

Urlep²,

Орел³

et al. 2021

Crohn’s Disease Recent Advances

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Exclusive enteral nutrition (EEN) has proven to be a highly effective treatment option in inducing remission in active Crohn’s disease (CD) in the paediatric population. In adults with CD, the results of meta-analyses demonstrated that therapy with corticosteroids was more effective in comparison with EEN. The most important limitation of the success of EEN treatment is patients’ compliance. Exclusivity of enteral nutrition and its substantial impact on the quality of life are the main reasons why EEN is not acceptable to many patients. Therefore, the treatment with partial enteral nutrition (PEN), where patients are allowed to eat some ordinary food besides enteral formulas, is becoming an important treatment option, not only in inducing, but also in maintaining remission in CD. However, strong evidence on the efficacy of PEN for induction and maintenance of CD remission is still lacking. Due to the excellent safety profile of the treatment with enteral nutrition in comparison with other treatment modalities, further well-designed, randomised, controlled studies are necessary to elucidate the exact role of PEN in inducing and maintaining of remission in CD patients. Herein, the most relevant studies on the efficacy and the role of PEN in active and quiescent CD are reviewed.

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“…PEN as maintenance of remission after the period of EEN is also not a well-accepted practice by patients and parents who advocate dietary advice rather than polymeric formula. Although they attribute beneficial effects to PEN as maintenance therapy, they issue negative comments that must be taken into account: "Made me feel sick and too full", "Looked like a medicine which put me off", "Easy to forget to take and bad taste and consistency", "They were ineffective as he became ill again" or "Suppress my child's appetite and make him too full" [150]. CDED is an effective alternative to PEN as a maintenance therapy.…”

Section: Advantages Of Cdedmentioning

confidence: 99%

EEN Yesterday and Today … CDED Today and Tomorrow

2020

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The treatment of Pediatric Crohn’s Disease (CD) requires attention both to achieve mucosal healing and to optimize growth, while also maintaining proper bone health. Exclusive Enteral Nutrition (EEN) is recommended as first-line treatment in luminal CD. The therapeutic mechanisms of EEN are being discovered by advances in the study of the gut microbiota. Although the total exclusion of a normal diet during the time of EEN continues to be of high importance, new modalities of dietary treatment suggest a successful future for the nutritional management of CD. In this sense, Crohn’s Disease Exclusion Diet (CDED) is a long-term strategy, it apparently acts on the mechanisms that influence the appearance of inflammation (reducing dietary exposure to products negatively affecting the microbiota), but does so using specific available whole foods to achieve this goal, increases the time of clinical remission and promotes healthy lifestyle habits. The development of CDED, which partly minimizes the problems of EEN, has enabled a turnaround in the treatment of pediatric CD. This review highlights the role of enteral nutrition in the treatment of Crohn’s disease with special emphasis on newer dietary modalities such as CDED.

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Patient, parent and professional perception of the use of maintenance enteral nutrition in Paediatric Crohn's Disease

Abstract: Patients' perception of the usefulness of MEN differs to professionals. This study highlights the extensive practice of MEN after EEN in clinical remission, which may not be nutritionally indicated. Patient preference is for dietary advice rather than MEN.

Cited by 7 publications

References 26 publications

Dietary Strategies for Maintenance of Clinical Remission in Inflammatory Bowel Diseases: Are We There Yet?

Dietary Strategies for Maintenance of Clinical Remission in Inflammatory Bowel Diseases: Are We There Yet?

Partial Enteral Nutrition in Crohn’s Disease

EEN Yesterday and Today … CDED Today and Tomorrow

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