Exclusive enteral nutrition for inducing remission in inflammatory bowel disease in paediatric patients

Amit Assa, Raanan Shamir

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

Purpose of review Enteral nutrition as a treatment for inflammatory bowel diseases is an ongoing area of interest. Even in the era of biologic agents, exclusive enteral nutrition (EEN) offers a unique, drug-free measure for induction of remission in luminal Crohn's disease. The purpose of this review is to discuss the role of EEN in the evolving therapeutic scheme for Crohn's disease, to report on new evidence for short and long-Term efficacy and highlight findings on the mechanisms of the anti-inflammatory effects of EEN in light of current understanding of disease pathogenesis. Recent findings Recent clinical studies have suggested that EEN has an established advantage over corticosteroids for inducing remission in children with luminal Crohn's disease with comparable clinical efficacy but superior mucosal healing effect as well as better safety profile. Preoperative EEN therapy can also improve postoperative outcome of intestinal resection. Basic research has demonstrated that EEN has direct anti-inflammatory properties, can correct localization of tight junction proteins, alter micro RNAs expression, and profoundly affect the intestinal microbiota. Summary EEN is an effective treatment for induction of remission in pediatric luminal Crohn's disease and should be offered as a first-line treatment. Accumulating evidence suggest that EEN has direct anti-inflammatory properties with an effect on the intestinal microbiota. However, the relationships between these effects and the specific triggers for these changes have yet to be elucidated.

Original languageEnglish
Pages (from-to)384-389
Number of pages6
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume20
Issue number5
DOIs
StatePublished - 1 Sep 2017
Externally publishedYes

Keywords

  • Crohn's disease
  • children
  • efficacy
  • mechanism

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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