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Treatment of inflammatory bowel disease in childhood
1Dept. of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, The Netherlands. j.c.escher@amc.uva.nl
Insights
Enteral nutrition is a key treatment for pediatric Crohn disease, improving nutrition and growth while avoiding steroid side effects. It may also help maintain remission in children with inflammatory bowel disease (IBD).
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease (IBD) Research
- Nutritional Therapy
Background:
- 20-30% of Crohn disease and ulcerative colitis cases present in childhood or adolescence.
- Accurate diagnosis is crucial as pediatric IBD treatment differs from adult protocols.
- Prepubertal diagnosis is common in pediatric IBD cases.
Purpose of the Study:
- To highlight the importance of accurate diagnosis in pediatric IBD.
- To emphasize the role of enteral nutrition in treating pediatric Crohn disease.
- To discuss the benefits and potential of enteral nutrition in managing pediatric IBD.
Main Methods:
- Review of current evidence on pediatric IBD treatment.
- Analysis of the efficacy of enteral feeding in pediatric Crohn disease.
- Comparison of pediatric and adult IBD therapeutic approaches.
Main Results:
- Enteral feeding is supported as primary therapy for pediatric Crohn disease.
- Enteral feeding improves nutrition, promotes growth and pubertal development, and avoids corticosteroid toxicity.
- Nocturnal enteral nutrition may prolong remission in pediatric IBD patients.
Conclusions:
- Enteral nutrition is a vital therapeutic strategy for pediatric Crohn disease.
- Further research is needed, particularly regarding drug treatment evidence in pediatric IBD.
- Accurate and timely diagnosis is essential for effective pediatric IBD management.
Abstract:
Of all patients with Crohn disease and ulcerative colitis, the first presentation of inflammatory bowel disease (IBD) is at a paediatric or adolescent age in 20% to 30%, most children being prepubertal at diagnosis. It is essential to provide an accurate diagnosis in children suspected of IBD, as the initial treatment of Crohn disease and ulcerative colitis in children is not the same as it is in adults. While the role of enteral feeding in the treatment of Crohn disease in adults continues to be controversial, there is firm evidence to support the use of enteral feeding as primary therapy for Crohn disease in children. Nutrition is improved by enteral feeding, and growth and pubertal development are promoted, while the systemic toxicity of corticosteroid therapy is avoided. Supplementary nocturnal enteral nutrition (with daytime intake of normal diet) after primary therapy and remission induction may be associated with the prolongation of remission. Drug treatment in children with IBD is characterized by a lack of evidence from controlled trials.