Exclusive enteral nutrition: An optimal care pathway for use in children with active luminal Crohn's disease

Area of Science:

• Pediatric Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Pathway Development

Background:

• Exclusive enteral nutrition (EEN) is a recommended first-line therapy for active luminal pediatric Crohn's disease.
• International variations in EEN protocols hinder consistent application.
• Standardization of EEN protocols is essential for effective therapy.

Purpose of the Study:

• To develop an optimal care pathway for the use of exclusive enteral nutrition (EEN) in children with active luminal Crohn's disease.
• To facilitate the standardization of clinical care for pediatric Crohn's disease patients undergoing EEN.
• To potentially improve clinical outcomes and guide future research in EEN therapy.

Main Methods:

• A working group of 11 pediatric gastroenterology dietitians and 1 pediatric gastroenterologist from Australia and New Zealand was formed.
• Seven key areas were identified: clinical indications, workup, EEN prescription, monitoring, food reintroduction, partial enteral nutrition, and maintenance enteral nutrition.
• Literature review, assessment using National Health and Medical Research Council guidelines, and consensus statements were employed, with expert opinion used to fill literature gaps.

Main Results:

• Nineteen consensus statements were agreed upon across the seven key areas.
• These consensus statements formed the basis of the optimal care pathway.
• The pathway is designed for children with active luminal Crohn's disease undergoing EEN in Australia and New Zealand.

Conclusions:

• An optimal care pathway for EEN in pediatric Crohn's disease was successfully developed.
• This pathway aims to standardize clinical care for children with active luminal Crohn's disease.
• The standardization is expected to improve clinical outcomes and identify areas for future research.