Abstract
Exclusive enteral nutrition (EEN) has proven to be a highly effective treatment option in inducing remission in active Crohn’s disease (CD) in the paediatric population. In adults with CD, the results of meta-analyses demonstrated that therapy with corticosteroids was more effective in comparison with EEN. The most important limitation of the success of EEN treatment is patients’ compliance. Exclusivity of enteral nutrition and its substantial impact on the quality of life are the main reasons why EEN is not acceptable to many patients. Therefore, the treatment with partial enteral nutrition (PEN), where patients are allowed to eat some ordinary food besides enteral formulas, is becoming an important treatment option, not only in inducing, but also in maintaining remission in CD. However, strong evidence on the efficacy of PEN for induction and maintenance of CD remission is still lacking. Due to the excellent safety profile of the treatment with enteral nutrition in comparison with other treatment modalities, further well-designed, randomised, controlled studies are necessary to elucidate the exact role of PEN in inducing and maintaining of remission in CD patients. Herein, the most relevant studies on the efficacy and the role of PEN in active and quiescent CD are reviewed.
Highlights
Crohn’s disease (CD) is a life-long immune-mediated inflammatory disease which may affect any part of the gastrointestinal tract
Beside to the basic methodology, research differed most in how much of a daily energy requirements patient received in the form of partial enteral nutrition (PEN) and what they enjoyed as the rest of their daily energy requirements, unrestricted diet or special elimination diets (ED)
The control group consisted of children, treated with enteral nutrition (EEN), with 100% of their daily energy requirements provided from the elemental enteral formula
Summary
Crohn’s disease (CD) is a life-long immune-mediated inflammatory disease which may affect any part of the gastrointestinal tract. The difference may be due to the lack of well-designed randomised controlled studies in adult CD population All formulas used for EEN are designed for oral use, many patients ( there are significant differences between parts of the world and between children and adults) accept them so poorly that they must be administered via a nasogastric tube To overcome this main constraint, the idea of the use of partial enteral nutrition (PEN) instead of EEN has emerged. We limited our systematic review to the efficacy of therapeutic approaches using PEN in combination with either unrestricted or specified ED for induction of CD remission in adults and children, while other nutritional treatment options are presented only in the outline of the discussion
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