P0667 EXCLUSIVE ENTERAL NUTRITION TO INDUCE REMISSION IN CROHN???S DISEASE

Abstract

Introduction: Following the initial diagnosis of acute Crohn’s disease in children, steroids are administered successfully to achieve remission. Undesirable side effects, e.g. on growth, weight and individual well-being have to be accepted. Thus, alternative therapies are urgently required. Methods: Initial diagnosis (endoscopy and histology) in 7 patients aged 12–15 years revealed Crohn’s disease. A therapy using exclusive enteral nutrition with Modulen IBD® (Nestle) was initiated and continued over a period of 8 weeks. After this period, a follow up endoscopy was performed. During the entire diet and food reintroduction, the patients were closely monitored together with a dietician. Results: All patients achieved subjective, clinical and endoscopic remission. There were no side effects or signs of intolerance. Only one patient received the diet via a nasogastric tube, the other patients drank it without any problems. For the first time since the onset of the disease a positive weight change could be noted, as well as an improved sense of well-being. One female patient had a flare after two months so that steroids eventually had to be administered. The other patients remained in remission over a period of so far 24 months. Conclusion: induce remission after first diagnosis of Crohn’s disease we successfully treated seven patients using exclusive enteral nutrition with a polymeric diet and without the use of steroids. Especially in puberty, this has a positive effect on growth, weight and the acceptance of the disease. With growing experience, we can confirm the positive results from other centers (Heuschkel RB et al., JPGN 2000, 31:8–15). Exclusive enteral nutrition should be the first line treatment of Crohn’s disease in children, a concept that is now about to conquer continental Europe.