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Nutrition issues in pediatric Crohn's disease
Anthony E Wiskin1, Stephen A Wootton, Robert M Beattie
1Paediatric Medical Unit, Southampton General Hospital, Southampton, UK.
Summary
Pediatric inflammatory bowel disease (IBD) often presents with poor nutrition and impaired growth. This review explores nutrition support, including exclusive enteral nutrition, for managing Crohn
Area of Science:
- Pediatric Gastroenterology and Nutrition
- Inflammatory Bowel Disease (IBD) Pathophysiology
Background:
- Twenty-five percent of inflammatory bowel disease (IBD) diagnoses occur in childhood, with Crohn's disease (CD) being the most prevalent type.
- Children with IBD frequently exhibit poor nutritional status at diagnosis, which can be exacerbated during the disease course, leading to impaired linear growth.
- Complex factors contribute to poor nutrition in pediatric IBD, including inadequate intake, malabsorption, increased energy demands, and nutrient losses.
Purpose of the Study:
- To explore the multifaceted factors influencing nutrition support for children with inflammatory bowel disease.
- To review the role of exclusive enteral nutrition (EEN) as a corticosteroid-sparing strategy for inducing remission in pediatric Crohn's disease.
Main Methods:
- Literature review examining the interplay between IBD, nutrition status, and growth in children.
- Analysis of current understanding regarding energy demands in pediatric CD and the impact of nutrition on disease progression.
- Evaluation of exclusive enteral nutrition as a therapeutic option for active Crohn's disease in children.
Main Results:
- Limited understanding exists regarding how the disease process affects energy demands in pediatric CD and how nutrition impacts the disease course.
- This knowledge gap may hinder the effectiveness of standard therapeutic interventions.
- Exclusive enteral nutrition is highlighted as a potential strategy for inducing remission and sparing corticosteroid use.
Conclusions:
- Effective medical management of pediatric IBD requires active consideration of children's nutritional needs to enable normal growth and development.
- Further research is needed to elucidate the complex relationship between energy metabolism, nutrition, and disease activity in pediatric IBD.
- Exclusive enteral nutrition presents a promising corticosteroid-sparing approach for managing active Crohn's disease in children.
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