Abstract
Enteral nutrition (EN) is considered to be of great importance in patients with inflammatory bowel disease (IBD) and nutritional problems. This comprehensive review is aiming to provide the reader with an update on the role of EN in IBD patients. EN can reduce Crohn's disease (CD) activity and maintain remission in both adults and children. Nutritional support using liquid formulas should be considered for CD patients and in serious cases of ulcerative colitis (UC), especially for those who may require prolonged cycles of corticosteroids. Given that the ultimate goal in the treatment of CD is mucosal healing, this advantage of EN over corticosteroid treatment is valuable in therapeutic decision-making. EN is indicated in active CD, in cases of steroid intolerance, in patient's refusal of steroids, in combination with steroids in undernourished individuals, and in patients with an inflammatory stenosis of the small intestine. No differences between the efficiency of elemental diets and nonelemental formulas have been noticed. EN must be the first choice compared to TPN. EN has a restricted value in the treatment of patients with large bowel CD. In conclusion, it seems important not to underestimate the role of nutrition as supportive care in patients with IBD.
Highlights
Nutritional disturbances represent a frequent manifestation of inflammatory bowel disease (IBD) patients, especially those with Crohn’s disease (CD)
According to recently released guidelines by the Austrian Working Group on Nutrition and IBD [1] and the British Dietetic Association [2], the existence of malnutrition should always be assessed in patients with IBD and weight loss (>5% within 3 months) and nutritional deficiencies or after extensive bowel resection [1], while enteral nutrition (EN) either elemental or nonelemental could be offered as an alternative option to induce disease remission [2]
The nutritional status in patients with IBD is of paramount clinical importance
Summary
Nutritional disturbances represent a frequent manifestation of inflammatory bowel disease (IBD) patients, especially those with Crohn’s disease (CD). According to recently released guidelines by the Austrian Working Group on Nutrition and IBD [1] and the British Dietetic Association [2], the existence of malnutrition should always be assessed in patients with IBD and weight loss (>5% within 3 months) and nutritional deficiencies or after extensive bowel resection [1], while enteral nutrition (EN) either elemental or nonelemental could be offered as an alternative option to induce disease remission [2]. Channeling the scientific community’s interest towards cheaper and safer treatment strategies, such as EN, was significantly promoted by the bad economic situation and the continuously rising cost of treatment of IBD patients.
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