scholarly journals Letter: reproducible evidence shows that exclusive enteral nutrition significantly reduces faecal calprotectin concentrations in children with active Crohn's disease

2017 ◽  
Vol 46 (11-12) ◽  
pp. 1119-1120 ◽  
Author(s):  
M. Logan ◽  
U. Z. Ijaz ◽  
R. Hansen ◽  
K. Gerasimidis ◽  
R. K. Russell
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Faecal Calprotectin ◽  
Exclusive Enteral Nutrition

scholarly journals Dietary Triggers of Gut Inflammation Following Exclusive Enteral Nutrition in Children with Crohn’s Disease: A Pilot Study

2021 ◽  
Author(s):  
Konstantinos Gkikas ◽  
Michael Logan ◽  
Ben Nichols ◽  
Umer Z. Ijaz ◽  
Clare M. Clark ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Processed Meat ◽  
Faecal Calprotectin ◽  
Exclusive Enteral Nutrition ◽  
Group A ◽  
Group B ◽  
Red And Processed Meat

Abstract Objectives:The anti-inflammatory effect of exclusive enteral nutritionon thegut of children with Crohn’s disease is rapidly lost after food reintroduction. This study assessed disease dietary triggers following successful treatment with exclusive enteral nutrition.Methods: Nutrient intake, dietary patterns and dietary biomarkers in faeces (gluten immunogenic peptides, undigestible starch, short chain fatty acids) were assessed in 14 children with Crohn’s disease during early food reintroduction, following exclusive enteral nutrition. Groups above (Group A) and below (Group B) the median levels of faecal calprotectin after food reintroduction were assigned for comparative analysis. Results:Intakes of fibre, gluten-containing cereals and red and processed meat were significantly higher in Group A than Group B;(median [Q1, Q3], grams; Fibre: 12.1 [11.2, 19.9] vs 9.9 [7.6, 12.1], p=0.03; Red and processed meat: 151 [66.7, 190] vs 63.3[21.7, 67], p=0.02; gluten-containing cereals: 289 [207, 402] vs 203 [61, 232], p=0.035). A diet consisting ofcereals and meat products was predictive (92% accuracy) of higher faecal calprotectin levels after food reintroduction. In faeces, butyrate levels, expressed as absolute concentration and relative abundance,were higher in Group A than Group B by 28.4 μmol/g (p=0.015)and 6.4% (p=0.008), respectively.Levels of gluten immunogenic peptide and starch in faeces did not differ between the two groups. Conclusions:This pilot study identified potential dietary triggers of gut inflammation in children with Crohn’s disease after food reintroduction following treatment with exclusive enteral nutrition.Trial registration: Clinical trials.gov registration number: NCT02341248; Clinical trials.gov URL:https://clinicaltrials.gov/ct2/show/NCT02341248 (retrospectively registered)

scholarly journals Dietary triggers of gut inflammation following exclusive enteral nutrition in children with Crohn’s disease: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Konstantinos Gkikas ◽  
Michael Logan ◽  
Ben Nichols ◽  
Umer Z. Ijaz ◽  
Clare M. Clark ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Pilot Study ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Processed Meat ◽  
Faecal Calprotectin ◽  
Exclusive Enteral Nutrition ◽  
Group A ◽  
Group B ◽  
Red And Processed Meat

Abstract Background The anti-inflammatory effect of exclusive enteral nutrition on the gut of children with Crohn’s disease is rapidly lost after food reintroduction. This study assessed disease dietary triggers following successful treatment with exclusive enteral nutrition. Methods Nutrient intake, dietary patterns and dietary biomarkers in faeces (gluten immunogenic peptides, undigestible starch, short chain fatty acids) were assessed in 14 children with Crohn’s disease during early food reintroduction, following exclusive enteral nutrition. Groups above (Group A) and below (Group B) the median levels of faecal calprotectin after food reintroduction were assigned for comparative analysis. Results Intakes of fibre, gluten-containing cereals and red and processed meat were significantly higher in Group A than Group B; (median [Q1, Q3], g/day; Fibre: 12.1 [11.2, 19.9] vs. 9.9 [7.6, 12.1], p = 0.03; Red and processed meat: 151 [66.7, 190] vs. 63.3 [21.7, 67], p = 0.02; gluten-containing cereals: 289 [207, 402] vs. 203 [61, 232], p = 0.035). A diet consisting of cereals and meat products was predictive (92% accuracy) of higher faecal calprotectin levels after food reintroduction. In faeces, butyrate levels, expressed as absolute concentration and relative abundance, were higher in Group A than Group B by 28.4 µmol/g (p = 0.015) and 6.4% (p = 0.008), respectively. Levels of gluten immunogenic peptide and starch in faeces did not differ between the two groups. Conclusions This pilot study identified potential dietary triggers of gut inflammation in children with Crohn’s disease after food reintroduction following treatment with exclusive enteral nutrition. Trial registration: Clinical trials.gov registration number: NCT02341248; Clinical trials.gov URL: https://clinicaltrials.gov/ct2/show/NCT02341248 (retrospectively registered).

scholarly journals Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1012
Author(s):  
Melinda Moriczi ◽  
Gemma Pujol-Muncunill ◽  
Rafael Martín-Masot ◽  
Santiago Jiménez Treviño ◽  
Oscar Segarra Cantón ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Disease Activity ◽  
Clinical Remission ◽  
Activity Index ◽  
Newly Diagnosed ◽  
Faecal Calprotectin ◽  
Exclusive Enteral Nutrition ◽  
Paediatric Crohn’S Disease

Exclusive enteral nutrition (EEN) has been shown to be more effective than corticosteroids in achieving mucosal healing in children with Crohn´s disease (CD) without the adverse effects of these drugs. The aims of this study were to determine the efficacy of EEN in terms of inducing clinical remission in children newly diagnosed with CD, to describe the predictive factors of response to EEN and the need for treatment with biological agents during the first 12 months of the disease. We conducted an observational retrospective multicentre study that included paediatric patients newly diagnosed with CD between 2014–2016 who underwent EEN. Two hundred and twenty-two patients (140 males) from 35 paediatric centres were included, with a mean age at diagnosis of 11.6 ± 2.5 years. The median EEN duration was 8 weeks (IQR 6.6–8.5), and 184 of the patients (83%) achieved clinical remission (weighted paediatric Crohn’s Disease activity index [wPCDAI] < 12.5). Faecal calprotectin (FC) levels (μg/g) decreased significantly after EEN (830 [IQR 500–1800] to 256 [IQR 120–585] p < 0.0001). Patients with wPCDAI ≤ 57.5, FC < 500 μg/g, CRP >15 mg/L and ileal involvement tended to respond better to EEN. EEN administered for 6–8 weeks is effective for inducing clinical remission. Due to the high response rate in our series, EEN should be used as the first-line therapy in luminal paediatric Crohn’s disease regardless of the location of disease and disease activity.

scholarly journals Duration of sustained remission after treatment by induction with exclusive enteral nutrition and azathioprine in patients with Crohn’s disease

2021 ◽  
Vol 94 (4) ◽  
pp. 252-253
Author(s):  
Alicia Isabel Pascual Pérez ◽  
Gemma Pujol Muncunill ◽  
Patricia Domínguez Sánchez ◽  
Sara Feo Ortega ◽  
Javier Martín de Carpi
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Sustained Remission ◽  
Exclusive Enteral Nutrition

scholarly journals Nutritional Therapy Strategies in Pediatric Crohn’s Disease

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 212
Author(s):  
Charlotte M. Verburgt ◽  
Mohammed Ghiboub ◽  
Marc A. Benninga ◽  
Wouter J. de Jonge ◽  
Johan E. Van Limbergen
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Intestinal Inflammation ◽  
Management Strategies ◽  
Nutritional Therapy ◽  
Nutritional Deficiencies ◽  
Intestinal Immunity ◽  
Exclusive Enteral Nutrition ◽  
Therapy Strategies

The increase in incidences of pediatric Crohn’s Disease (CD) worldwide has been strongly linked with dietary shifts towards a Westernized diet, ultimately leading to altered gut microbiota and disturbance in intestinal immunity and the metabolome. Multiple clinical studies in children with CD have demonstrated the high efficacy of nutritional therapy with exclusive enteral nutrition (EEN) to induce remission with an excellent safety profile. However, EEN is poorly tolerated, limiting its compliance and clinical application. This has spiked an interest in the development of alternative and better-tolerated nutritional therapy strategies. Several nutritional therapies have now been designed not only to treat the nutritional deficiencies seen in children with active CD but also to correct dysbiosis and reduce intestinal inflammation. In this review, we report the most recent insights regarding nutritional strategies in children with active CD: EEN, partial enteral nutrition (PEN), Crohn’s disease exclusion diet (CDED), and CD treatment-with-eating diet (CD-TREAT). We describe their setup, efficacy, safety, and (dis)advantages as well as some of their potential mechanisms of action and perspectives. A better understanding of different nutritional therapeutic options and their mechanisms will yield better and safer management strategies for children with CD and may address the barriers and limitations of current strategies in children.

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