The efficacy of total enteral nutrition in inducing remission and improving nutritional status in children with moderate to severe Crohn’s disease

Introduction: Growth retardation and malnutrition are very common complications of Crohn’s disease in children. Total enteral nutrition (TEN) may be considered as therapeutic approach in active disease.

Aim: To assess the efficacy of enteral nutrition in inducing remission in children with active Crohn’s disease and compare it with conventional steroid therapy.

Material and methods: The study group consisted of 20 children with active Crohn’s disease. All patients were placed

on a total enteral nutrition regimen in hospital which was continued for 6 weeks at home. Children were examined

at the time of recruitment and after 2 weeks of TEN. Those who reached remission (n = 8) were followed up for the next 12 months. Clinical condition expressed by PCDAI, blood tests and nutritional status were analyzed. The control group consisted of 24 children with active Crohn’s disease treated with conventional steroid therapy.

Results: Remission was achieved in 40% of patients on enteral nutrition and 45.8% on steroid therapy, respectively. In both groups duration of remission was 12 months at most. In the study group there was a significant increase in body weight, body mass index and lean body mass (LBM).

Conclusions: Enteral nutrition is an effective treatment in inducing remission in children with active and moderate Crohn’s disease. It can suppress gut inflammation and improve growth. Its effectiveness is comparable to conventional steroid therapy.