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[Effectiveness of induction therapy with exclusive enteral nutrition in pediatric Crohn's disease]
You-You Luo1, You-Hong Fang1, Jin-Dan Yu1
1Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine/National Clinical Research Center for Child Health, Hangzhou 310052, China.
Insights
Exclusive enteral nutrition (EEN) effectively induces clinical remission and promotes mucosal healing in pediatric Crohn's disease (CD). This treatment also improves height and BMI in children who achieve remission.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Nutritional Therapy
Background:
- Pediatric Crohn's disease (CD) is a chronic inflammatory condition requiring effective management strategies.
- Exclusive enteral nutrition (EEN) is a recognized therapeutic option for inducing remission in pediatric CD.
Purpose of the Study:
- To evaluate the efficacy of 8-week exclusive enteral nutrition (EEN) as induction therapy in pediatric Crohn's disease (CD).
Main Methods:
- Retrospective analysis of 62 pediatric CD patients treated with EEN from March 2013 to August 2021.
- Assessed clinical remission (PCDAI), mucosal healing, C-reactive protein, ESR, albumin, and growth parameters (height, BMI) before and after 8 weeks of EEN.
Main Results:
- 87% of 55 children achieved clinical remission after 8 weeks of EEN.
- 83% of evaluated patients demonstrated mucosal healing.
- Children achieving remission showed significant improvements in height-for-age and BMI-for-age Z-scores.
Conclusions:
- Eight-week EEN is effective for inducing clinical remission and mucosal healing in pediatric CD.
- EEN positively impacts growth parameters (height, BMI) in pediatric CD patients who achieve clinical remission.
Objectives:
To evaluate the effectiveness of induction therapy with exclusive enteral nutrition (EEN) in pediatric Crohn's disease (CD).
Methods:
A retrospective analysis was performed on the medical data of 62 children with CD who received EEN in Children's Hospital, Zhejiang University School of Medicine, from March 2013 to August 2021. The medical data included general information and height, weight, Pediatric Crohn's Disease Activity Index (PCDAI), Crohn's Disease Endoscopic Index of Severity, C-reactive protein, erythrocyte sedimentation rate, and serum albumin level before treatment and after 8 weeks of treatment. The changes in the above indicators were compared before and after treatment.
Results:
Among the 62 children with CD, there were 39 boys (63%) and 23 girls (37%), with a mean age of (11.9±3.0) years at diagnosis. Among the 55 children who completed EEN treatment for at least 8 weeks, 48 (87%) achieved clinical remission at week 8. PCDAI at week 8 was significantly lower than that before treatment (P<0.001). Except for 17 children with involvement of the small intestine alone and 3 children with involvement of the colon who did not receive colonoscopy reexamination, the remaining 35 children with involvement of the colon received colonoscopy reexamination after the 8-week EEN treatment. Of the 35 children, 29 (83%) achieved mucosal healing. As for the 48 children who achieved clinical remission at week 8, there were significant improvements in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P<0.01). As for the 7 children who did not achieve clinical remission at week 8, there were no significant changes in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P>0.05).
Conclusions:
The 8-week EEN treatment has a good effect on clinical remission and mucosal healing in children with CD. For the children with CD achieving clinical remission, EEN can improve their height and body mass index.
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