Use of Enteral Nutrition for the Control of Intestinal Inflammation in Pediatric Crohn Disease

Division of Gastroenterology, Janeway Children's Health Center, Memorial University, St John's, Newfoundland and Labrador, Canada.
Journal of pediatric gastroenterology and nutrition (Impact Factor: 2.63). 02/2012; 54(2):298-305. DOI: 10.1097/MPG.0b013e318235b397
Source: PubMed


Exclusive enteral nutrition is an effective yet often underused therapy for the induction of remission in pediatric Crohn disease. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition formed the Enteral Nutrition Working Group to review the use of enteral nutrition therapy in pediatric Crohn disease. The group was composed of 5 pediatric gastroenterologists and 1 pediatric nutritionist, all with an interest and/or expertise in exclusive enteral nutrition. Specific attention was placed upon review of the evidence for efficacy of therapy, assessment of the variations in care, identification of barriers to its widespread use, and compilation of the necessary components for a successful program. The present guideline is intended to aid physicians in developing an enteral nutrition therapy program and potentially promote its use.

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    • "Generally, when considering medical nutrition interventions, clinical evidence of their efficacy in supporting the recovery of patients has been demonstrated for different disease areas (for example, in critically ill patients,7,8 pancreatitis,9 and patients suffering from dysphagia10). Similarly, in pediatric Crohn’s disease patients, the use of enteral nutrition during flare-ups of the disease has been shown to induce remission as effectively as corticosteroids, and even more safely.11 Furthermore, the clinical evidence for the efficacy of medical nutrition in supporting the recovery of patients with disease-related malnutrition has been extensively documented, and it has shown a reduction in mortality, morbidity, as well as in the length of hospitalization and rehospitalizations.12 "
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    • "The choice of formula is probably also dictated by clinician experience, funding, and local availability [38]. There are no controlled trials that have studied the appropriate length of treatment, but current practice appears to be based on most studies reporting the occurrence of clinical remission within this period [35] [36] [38]. Small amounts of water or beverages are allowed in this period. "
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