Abstract
Background and AimExclusive enteral nutrition (EEN) is progressively being used as a therapeutic option for adults with Crohn's Disease (CD); however, there is no standardized approach to delivering this therapy. The aim of this study is to develop an optimal care pathway for using EEN in adults with CD. This will create a standard of care that can be used as a benchmark practice and will provide direction for future research.MethodsA working group of 12 multidisciplinary inflammatory bowel disease specialists across Australia and New Zealand was convened to develop a practical, clinically focused care pathway for using EEN in adults with active CD. Six key areas were identified as part of the care pathway: clinical indications, nutrition assessment, EEN protocol, monitoring, accessing formula, and food reintroduction. Current literature was identified via systematic review, and quality of evidence was graded. Consensus expert opinion was used where literature gaps were identified.ResultsAn optimal care pathway for using EEN in adults with CD was developed with six key consensus statements on how to use EEN in adults with active CD. These key statements identify clinical indications for use, nutrition assessment, enteral prescription and duration of therapy, monitoring criteria, food reintroduction, and the role of partial EEN. An accompanying patient resource was also developed.ConclusionEEN is recommended as a treatment option to induce remission in adults with active CD. The consensus statements developed are practical and are based on best available evidence and expert opinion to assist in developing a standardized approach to delivering EEN therapy.
Highlights
The role of exclusive enteral nutrition (EEN) in the management of adult patients with active Crohn’s disease (CD) is evolving
Clinicians were defined as adult inflammatory bowel disease (IBD) experts if they were currently working in IBD services in Australia and New Zealand where EEN therapy is used
Six key areas for an optimal care pathway were identified by group consensus: clinical indications, nutrition assessment, EEN protocol, monitoring, accessing formula, and food reintroduction
Summary
The role of exclusive enteral nutrition (EEN) in the management of adult patients with active Crohn’s disease (CD) is evolving. The basic premise of efficacy is the same as pediatric patients, yet few studies have been conducted on the adult cohort This difference has been attributed to the lack of access to a multidisciplinary team, perceived intolerance and noncompliance in adults, and a lack of experience amongst inflammatory bowel disease (IBD) physicians.[1] Subsequently, clinical guidelines for using EEN therapy in adults with active CD have not been developed. These key statements identify clinical indications for use, nutrition assessment, enteral prescription and duration of therapy, monitoring criteria, food reintroduction, and the role of partial EEN. The consensus statements developed are practical and are based on best available evidence and expert opinion to assist in developing a standardized approach to delivering EEN therapy
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
