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Nutritional Approach in Pediatric Patients with Inflammatory Bowel Disease: Treatment, Risk and Challenges
Maria Elena Capra1, Arianna Maria Bellani2,3, Martina Berzieri2,3
1Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy.
Insights
Nutritional interventions are crucial for pediatric Inflammatory Bowel Diseases (IBD). Exclusive enteral nutrition (EEN) effectively induces remission in pediatric Crohn
Area of Science:
- Pediatric Gastroenterology and Nutrition
- Inflammatory Bowel Disease (IBD) Management
Background:
- Pediatric Inflammatory Bowel Diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), pose unique challenges such as growth impairment and psychosocial difficulties.
- Nutritional interventions are a cornerstone of pediatric IBD management, complementing advanced biologic and targeted therapies.
Purpose of the Study:
- To review current evidence on nutritional strategies for managing pediatric IBD.
- To highlight the therapeutic potential and limitations of various dietary interventions.
- To emphasize the integration of nutrition with pharmacologic treatment in a multidisciplinary approach.
Main Methods:
- Narrative review of existing literature on nutritional interventions in pediatric IBD.
- Analysis of studies evaluating exclusive enteral nutrition (EEN), modified diets (e.g., Crohn's Disease Exclusion Diet - CDED), and general dietary patterns.
Main Results:
- Exclusive enteral nutrition (EEN) is a first-line therapy for inducing remission in pediatric Crohn's disease, with efficacy comparable to corticosteroids and added benefits for mucosal healing and growth.
- Modified dietary approaches like partial enteral nutrition and CDED show promise for improving adherence and remission maintenance in pediatric CD.
- The role of nutrition in ulcerative colitis is less defined, but anti-inflammatory diets may be beneficial.
Conclusions:
- Nutritional strategies, particularly EEN, are vital for inducing remission and improving outcomes in pediatric Crohn's disease.
- Individualized, dietitian-supervised nutritional care is essential to mitigate risks of deficiencies and psychosocial stress associated with dietary restrictions.
- A multidisciplinary approach integrating nutritional support with pharmacologic treatments is key to optimizing quality of life for children with IBD.
Abstract:
Inflammatory Bowel Diseases (IBDs), including Crohn's disease (CD) and ulcerative colitis (UC), have become a growing global health concern in children and adolescents. Pediatric-onset IBD presents unique challenges compared with adult-onset forms, including more extensive disease, impaired growth, delayed puberty, and psychosocial difficulties. While biologic and targeted therapies have advanced disease control, nutritional interventions remain a central component of management. Exclusive enteral nutrition (EEN) is recognized as the first-line therapy for inducing remission in pediatric CD, offering comparable efficacy to corticosteroids with additional benefits for mucosal healing, nutritional status, and growth. Modified dietary approaches, such as partial enteral nutrition and the Crohn's Disease Exclusion Diet (CDED), show promise for improving adherence and maintaining remission. However, dietary restrictions may lead to deficiencies and psychosocial stress, underscoring the importance of individualized, dietitian-supervised care. The role of nutrition in UC is less defined, but balanced, anti-inflammatory dietary patterns appear beneficial. This narrative review summarizes current evidence on nutritional strategies in pediatric IBD, highlighting their therapeutic potential, limitations, and integration with pharmacologic treatment within a multidisciplinary framework aimed at optimizing outcomes and quality of life.
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