Abstract
The treatment of Pediatric Crohn’s Disease (CD) requires attention both to achieve mucosal healing and to optimize growth, while also maintaining proper bone health. Exclusive Enteral Nutrition (EEN) is recommended as first-line treatment in luminal CD. The therapeutic mechanisms of EEN are being discovered by advances in the study of the gut microbiota. Although the total exclusion of a normal diet during the time of EEN continues to be of high importance, new modalities of dietary treatment suggest a successful future for the nutritional management of CD. In this sense, Crohn’s Disease Exclusion Diet (CDED) is a long-term strategy, it apparently acts on the mechanisms that influence the appearance of inflammation (reducing dietary exposure to products negatively affecting the microbiota), but does so using specific available whole foods to achieve this goal, increases the time of clinical remission and promotes healthy lifestyle habits. The development of CDED, which partly minimizes the problems of EEN, has enabled a turnaround in the treatment of pediatric CD. This review highlights the role of enteral nutrition in the treatment of Crohn’s disease with special emphasis on newer dietary modalities such as CDED.
Highlights
Crohn’s disease (CD) is a chronic idiopathic inflammatory disorder characterized by periods of inflammatory activity that alternate with others of remission
Despite the important role that the dietitian plays within this support system and its recognized importance in the treatment of pediatric CD [129], it should be emphasized that Spain continues to be the only country in Europe that does not incorporate this figure within the public health system, which could be a limiting factor when incorporating this dietary treatment in our country [155]
Enteral Nutrition (EEN) is recommended as first-line treatment in luminal
Summary
Crohn’s disease (CD) is a chronic idiopathic inflammatory disorder characterized by periods of inflammatory activity that alternate with others of remission. 10–25% of cases of inflammatory bowel disease (IBD) are diagnosed before 21 years of age [1], with a peak of maximum incidence during childhood between 13–15 years [2,3]. This period is critical [4,5] since important physical changes take place [6] with a rapid growth rate. The therapeutic objectives in CD are the control of inflammation, mucosal healing, modification of the course of the disease, avoiding the undesirable effects of treatment and guaranteeing adequate growth and development [10].
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