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Elemental versus polymeric enteral nutrition in paediatric Crohn's disease: a multicentre randomized controlled trial

J F Ludvigsson1, M Krantz, L Bodin

  • 1Department of Paediatrics, Orebro University Hospital, Orebro, Sweden. jonasludvigsson@yahoo.com

Acta Paediatrica (Oslo, Norway : 1992)
|May 6, 2004
PubMed

Insights

For active pediatric Crohn's disease, both elemental and polymeric diets achieved similar remission rates. However, the polymeric diet led to significantly greater weight gain in children compared to the elemental diet.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Inflammatory Bowel Disease Research

Background:

  • Crohn's disease is a chronic inflammatory bowel disease affecting children.
  • Nutritional therapy, including elemental and polymeric diets, is a primary treatment for active pediatric Crohn's disease.
  • Comparing the efficacy and safety of different nutritional approaches is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of an elemental diet versus a polymeric diet as primary therapy for active Crohn's disease in children.
  • To evaluate remission rates and weight gain in pediatric patients receiving either diet.

Main Methods:

  • A randomized, controlled trial conducted in Sweden.
  • 16 children with Crohn's disease received Elemental 028 Extra (E028E), and 17 received Nutrison Standard (NuS).
  • Remission was assessed at 6 weeks using the Paediatric Crohn's Disease Activity Index (PCDAI).

Main Results:

  • No significant difference in remission rates between the elemental (69%) and polymeric (82%) diet groups (p = 0.438).
  • Patients on the polymeric diet gained significantly more weight (+2.5 kg, p = 0.004) than those on the elemental diet.
  • No difference in PCDAI or CDAI decrease between groups; side effects were observed in 5/33 patients.

Conclusions:

  • Elemental and polymeric diets demonstrate comparable efficacy in achieving remission for pediatric Crohn's disease.
  • Polymeric diets may be superior to elemental diets when weight gain is a primary therapeutic goal.
  • Nutritional therapy choice should consider individual patient needs and treatment objectives.
Abstract

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