768 Exclusive Enteral Nutrition in Paediatric Crohn's Disease

Abstract

Background: The British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) guidance (October 2008) advocates the use of Exclusive Enteral Nutrition (EEN) as an alternative first line treatment to oral corticosteroids for induction of remission in paediatric Crohn's disease. Compared to steroids, EEN is not known to produce any harmful consequences. Aims: To assess whether EEN was being offered at two neighbouring district general hospitals (DGHs) in accordance with BSPGHAN standards and whether EEN courses were producing a remission rate similar to that in the literature. Methods: All patients on the Crohn's Disease Register were included. Data was collected from medical and dietician records and analysed using Microsoft Excel. Results: 95% children were offered and tolerated a full course of EEN. 83% EEN courses lasted 6-8 weeks. Remission was acheived in 78% overall (consistent with the literature). The length of period for food reintroduction was much more variable. Average number of dietician consultations for induction of remission and food reintroduction were also variable. 71% of those patients who achieved complete remission with EEN had a relapse ( 3 years). Conclusions: EEN was widely used in both the DGH settings. It was tolerated well and proved to be an effective treatment acheiving complete remission in 78% of patients. Our findings support the use of EEN as a first line treatment for paediatric crohn's disease. There is a need for more collabortive research and regular audits into the care of paediatric Crohn's disease patients.