The Role of Enteral Nutritional Therapy in Inflammatory Bowel Disease

2015 ◽  
Author(s):  
Lindsey Albenberg ◽  
Robert Baldassano
Keyword(s):  
Inflammatory Bowel Disease ◽  
Enteral Nutrition ◽  
Mechanism Of Action ◽  
Bowel Disease ◽  
Nutritional Therapy ◽  
Nutrition Therapy ◽  
Poor Growth ◽  
Inflammatory Bowel ◽  
Maintenance Of Remission ◽  
The Impact

Enteral nutrition therapy is a dietary treatment regimen for inflammatory bowel disease that has the benefit of avoiding suppression of the immune system. Its mechanism of action has not been well characterized, but may be related to the elimination of dietary antigens or modulation of the gut microbiota. This treatment has shown success for induction of remission, and may also have a role in maintenance of remission. In the pediatric population, enteral nutrition therapy has the dual benefit of targeting both the inflammatory processes and the poor growth of these patients. This review details the administration and mechanism of action of enteral nutritional therapy, the induction and maintenance of remission, the impact of enteral nutritional therapy on growth and nutrition, and side effects and quality of life. A table summarizes studies investigating enteral nutritional therapy for induction of remission. This review contains 1 table and 49 references.

11 ENTERAL NUTRITION THERAPY IS ASSOCIATED WITH FEWER READMISSIONS AND DEATHS AMONG MALNOURISHED INPATIENTS WITH INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S43-S44
Author(s):  
Wendi LeBrett ◽  
Jenny Sauk ◽  
Berkeley Limketkai
Keyword(s):  
Inflammatory Bowel Disease ◽  
Propensity Score ◽  
Enteral Nutrition ◽  
Bowel Disease ◽  
Nutrition Therapy ◽  
Control Group ◽  
Protein Calorie Malnutrition ◽  
Inflammatory Bowel ◽  
Matched Study ◽  
The Impact

Abstract Background Malnutrition is a common complication observed in hospitalized patients with inflammatory bowel disease (IBD). Enteral nutrition therapy can be used to support the nutritional needs of inpatients with IBD. However, evidence on the impact of inpatient enteral nutrition on clinical outcomes is equivocal. This study assesses post-hospitalization outcomes associated with enteral nutrition therapy amongst inpatients with IBD in a large nationwide database. Methods We conducted a retrospective propensity score-matched study among IBD inpatients diagnosed with protein-calorie malnutrition using the Nationwide Readmissions Database from 2010–2015. ICD9 codes associated with each admission were used to identify patients who received enteral nutrition. Using propensity score matching, patients who received inpatient enteral nutrition were matched with patients who did not receive enteral nutrition based on the following variables: age, sex, elective admission, patient income, teaching hospital, and hospital urban or rural locality. Primary endpoints included 30-day readmissions, 90-day readmissions, 30-day mortality and 90-day mortality. Results Among the 1,588 IBD patients (822 Crohn’s disease, 755 ulcerative colitis, 11 unclassified IBD) with protein-calorie malnutrition, patients who received enteral nutrition (n=794) had fewer 30-day readmissions (OR 0.73; 95% CI 0.55 – 0.96) and 90-day readmissions (OR 0.77; 95% CI 0.61 – 0.97). None of the patients (0%) in the enteral nutrition group died on a subsequent admission within 30 days of discharge, compared to 6 patients (0.8%) in the control group (p=0.027). Inpatient mortality within 90 days of discharge did not differ significantly between the two groups (0.8%, enteral nutrition vs. 1.6%, control; p=0.086). Discussion Enteral nutrition therapy among IBD inpatients with malnutrition was associated with lower odds of readmission and 30-day mortality, but not 90-day mortality. The findings of our study support the use of enteral nutrition in IBD inpatients and motivate the need for prospective studies assessing the impact of enteral nutritional support in IBD inpatients.

scholarly journals Treatment of Inflammatory Bowel Disease in Children

1990 ◽  
Vol 4 (7) ◽  
pp. 404-406 ◽  
Author(s):  
D Grant Gall
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Bowel Disease ◽  
Growth Failure ◽  
Nutritional Therapy ◽  
Inflammatory Bowel

As no curative therapy exists, supportive measures play an important role in the management of patients with inflammatory bowel disease (IBO). Aminosalicylic acid (ASA) compounds and corticosteroids remain the mainstay of medical therapy. Aminosalicylates are recommended for therapy of mild to moderate active ulcerative colitis and for the maintenance of remission in ulcerative colitis. The role of 5-ASA preparations in Crohn's disease is less clear. In granulomatous colitis, 5-ASA therapy is recommended. With the development of new delivery systems, the role for 5-ASA in the treatment of small bowel Crohn's disease is under investigation. Prednisone remains the drug of choice in severe ulcerative colitis and active Crohn's disease. The role of immunosuppressive drugs in pediatric patients is unclear. Nutritional therapy has been an important advance in the treatment of children with Crohn's disease, especially those with growth failure. Nutritional therapy can consist of combined total parenteral and enteral nutrition or enteral nutrition alone. An initial period of total parenteral nutrition followed by a six to eight week course of enteral therapy with a semisynthetic diet has been shown to be effective in the management of patients with severe active disease and growth failure.

scholarly journals Enteral Nutrition in Crohn’s Disease: An Underused Therapy

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
S. Kansal ◽  
J. Wagner ◽  
C. D. Kirkwood ◽  
A. G. Catto-Smith
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Enteral Nutrition ◽  
Mechanism Of Action ◽  
Bowel Disease ◽  
Safety Profile ◽  
Adult Patients ◽  
Exclusive Enteral Nutrition ◽  
Inflammatory Bowel ◽  
Putative Mechanism

This paper reviews the literature on the history, efficacy, and putative mechanism of action of enteral nutrition for inflammatory bowel disease in both paediatric and adult patients. It also analyses the reasoning behind the low popularity of exclusive enteral nutrition in clinical practice despite the benefits and safety profile.

scholarly journals Exploitation of Marine-Derived Robust Biological Molecules to Manage Inflammatory Bowel Disease

Marine Drugs ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 196
Author(s):  
Muhammad Bilal ◽  
Leonardo Vieira Nunes ◽  
Marco Thúlio Saviatto Duarte ◽  
Luiz Fernando Romanholo Ferreira ◽  
Renato Nery Soriano ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bioactive Compounds ◽  
Bowel Disease ◽  
Clinical Translation ◽  
Biologically Active ◽  
Naturally Occurring ◽  
Inflammatory Bowel ◽  
Functional Features ◽  
Biological Entities ◽  
The Impact

Naturally occurring biological entities with extractable and tunable structural and functional characteristics, along with therapeutic attributes, are of supreme interest for strengthening the twenty-first-century biomedical settings. Irrespective of ongoing technological and clinical advancement, traditional medicinal practices to address and manage inflammatory bowel disease (IBD) are inefficient and the effect of the administered therapeutic cues is limited. The reasonable immune response or invasion should also be circumvented for successful clinical translation of engineered cues as highly efficient and robust bioactive entities. In this context, research is underway worldwide, and researchers have redirected or regained their interests in valorizing the naturally occurring biological entities/resources, for example, algal biome so-called “treasure of untouched or underexploited sources”. Algal biome from the marine environment is an immense source of excellence that has also been demonstrated as a source of bioactive compounds with unique chemical, structural, and functional features. Moreover, the molecular modeling and synthesis of new drugs based on marine-derived therapeutic and biological cues can show greater efficacy and specificity for the therapeutics. Herein, an effort has been made to cover the existing literature gap on the exploitation of naturally occurring biological entities/resources to address and efficiently manage IBD. Following a brief background study, a focus was given to design characteristics, performance evaluation of engineered cues, and point-of-care IBD therapeutics of diverse bioactive compounds from the algal biome. Noteworthy potentialities of marine-derived biologically active compounds have also been spotlighted to underlying the impact role of bio-active elements with the related pathways. The current review is also focused on the applied standpoint and clinical translation of marine-derived bioactive compounds. Furthermore, a detailed overview of clinical applications and future perspectives are also given in this review.

GUT-DIRECTED SELF-HYPNOSIS FOR INFLAMMATORY BOWEL DISEASE PROTOCOL: COMPLIMENTARY PSYCHOTHERAPY FOR REMISSION AUGMENTATION, IBS-LIKE SYMPTOMS, AND SURGERY RECOVERY

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S53-S53
Author(s):  
Joshua Paulton ◽  
Amanjot Gill ◽  
Joelle Prevost
Keyword(s):  
Inflammatory Bowel Disease ◽  
Stress Response ◽  
Mechanism Of Action ◽  
Bowel Disease ◽  
Relaxation Techniques ◽  
Markers Of Inflammation ◽  
Post Surgery ◽  
Patient Goals ◽  
History Of ◽  
Inflammatory Bowel

Abstract Background Gut-directed hypnosis (GDH) is a complimentary therapy for Inflammatory Bowel Disease (IBD), that can be learnt by patients to practice self-hypnosis. GDH in IBD has augmented remission and improved inflammation. GDH has a history of successful use for Irritable Bowel Syndrome (IBS). In IBD it may also improve IBS-like symptoms in remission and recovery from surgery. GDH is suitable for youth and adult IBD patients. In hypnosis, a relaxed state is inducted then suggestions to subconscious mind processes are made. In IBD, the mechanism of action of GDH is unknown but may influence the disease stress response. Aims Aims are the development of a GDH self-hypnosis protocol for IBD, with appropriate target symptoms. Patients first learn to practice with a clinician, then as complimentary psychotherapy for remission augmentation, IBS-like symptoms, and surgery recovery. Methods GDH is practiced first with a clinician, and then by patients as self-hypnosis (table 1). Patients receive psycho-education on GDH for IBD. Next, appropriate treatment goals are made, based on target symptoms. Relaxation techniques induce patient to a deeply relaxed state. Therapeutic suggestions specific to patient goals are given: verbal suggestions, visualizations, and post-hypnotic suggestions. Suggestions can focus on having a healthy digestive system, inflammation and symptoms reduction, and achievement and sustainment of remission. Patients emerge from hypnosis, are debriefed, and encouraged to practice ongoing self-hypnosis. Results In IBD, GDH self-hypnosis can be learnt from clinicians and practiced by patients as a complimentary therapy. Patients’ achievement and sustainment of remission, with clinical markers of inflammation can be monitored. Patients can monitor subjective improvement of IBS-like symptoms and post surgery, recovery progress can be monitored. Conclusions GDH has a history of use for IBS. In IBD, it has been shown to modulate remission, and may improve IBS-like symptoms, and in surgery recovery. The mechanism of action of GDH in IBD may influence the disease stress response. Clinicians trained in GDH are limited currently. Patients may learn GDH self- hypnosis to as a complimentary psychotherapy.

scholarly journals Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice

2020 ◽  
Vol 4 (1) ◽  
pp. e000786
Author(s):  
Abbie Maclean ◽  
James J Ashton ◽  
Vikki Garrick ◽  
R Mark Beattie ◽  
Richard Hansen
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Delayed Diagnosis ◽  
High Standard ◽  
Current Evidence ◽  
Faecal Calprotectin ◽  
Paediatric Patients ◽  
Inflammatory Bowel ◽  
Working Practices ◽  
The Impact

The assessment and management of patients with known, or suspected, paediatric inflammatory bowel disease (PIBD) has been hugely impacted by the COVID-19 pandemic. Although current evidence of the impact of COVID-19 infection in children with PIBD has provided a degree of reassurance, there continues to be the potential for significant secondary harm caused by the changes to normal working practices and reorganisation of services.Disruption to the normal running of diagnostic and assessment procedures, such as endoscopy, has resulted in the potential for secondary harm to patients including delayed diagnosis and delay in treatment. Difficult management decisions have been made in order to minimise COVID-19 risk for this patient group while avoiding harm. Initiating and continuing immunosuppressive and biological therapies in the absence of normal surveillance and diagnostic procedures have posed many challenges.Despite this, changes to working practices, including virtual clinic appointments, home faecal calprotectin testing kits and continued intensive support from clinical nurse specialists and other members of the multidisciplinary team, have resulted in patients still receiving a high standard of care, with those who require face-to-face intervention being highlighted.These changes have the potential to revolutionise the way in which patients receive routine care in the future, with the inclusion of telemedicine increasingly attractive for stable patients. There is also the need to use lessons learnt from this pandemic to plan for a possible second wave, or future pandemics as well as implementing some permanent changes to normal working practices.In this review, we describe the diagnosis, management and direct impact of COVID-19 in paediatric patients with IBD. We summarise the guidance and describe the implemented changes, evolving evidence and the implications of this virus on paediatric patients with IBD and working practices.

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