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News

Exclusive enteral nutrition improves pediatric Crohn's disease

A study published in the latest issue of the Alimentary Pharmacology & Therapeutics reports clinical progress in the 2 years following a course of exclusive enteral nutrition in pediatric patients with Crohn's disease.

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Exclusive enteral nutrition is an effective first line treatment for active pediatric Crohn's disease.

Dr Cameron and colleagues examined the effect of exclusive enteral nutrition on short- and long-term clinical outcome together with anthropometric measurements.

The research team reported that the retrospective case-note review in newly diagnosed Crohn's disease who completed 8 weeks of exclusive enteral nutrition.

Demographics, anthropometry, disease characteristics and inflammatory markers were collected at exclusive enteral nutrition initiation and at 1, 2, 6, 12 & 24 months post treatment initiation.

The doctors assessed that exclusive enteral nutrition response was determined by a patient global assessment.

The team evaluated 109 patients.

The research team reported that after 8 weeks exclusive enteral nutrition, 65 were in remission, 32 improved and 12 had no improvement.

By 4 weeks, mean weight/BMI z-score increased.

The team noted that between 4 and 8 weeks, baseline inflammatory markers all improved significantly by week 4 and ESR.

The research team observed that 63 out of 109 patients relapsed during follow-up.

70% of patients who relapsed managed a 2nd course of exclusive enteral nutrition
Alimentary Pharmacology & Therapeutics

The team found that 44 out of these 63 patients completed a second course of exclusive enteral nutrition with similar response rate, but lower weight gain.

The doctors assessed that height z-score did not change significantly over the 24 months.

Introduction of azathioprine within 6 months of diagnosis did not improve height outcomes at 24 months.

Weight and BMI z-score improved with Exclusive enteral nutrition and changes are sustained to 2 years, but height z-score did not.

Dr Cameron's team concluded, "About 70% of patients who relapsed during 2-year follow-up managed a 2nd course of exclusive enteral nutrition."

"The optimal therapeutic strategies for length of exclusive enteral nutrition course and to improve linear growth are awaited."

Aliment Pharmacol Ther 2013: 37(6): 622-629
19 February 2013

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