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Clinical Nutrition

Outcomes of exclusive enteral nutrition in paediatric Crohn’s disease

European Journal of Clinical Nutrition volume 71, pages 185–191 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Exclusive enteral nutrition (EEN) is a safe and effective treatment modality for inducing remission in paediatric Crohn’s disease (CD). The primary aim of this study was to compare the outcomes of EEN to corticosteroid (CS) therapy in newly diagnosed, treatment-naïve patients with CD. A secondary aim was to describe the outcomes of EEN in a national cohort of paediatric CD patients over a 10-year period.

Subjects/Methods:

A retrospective chart review was conducted at the Irish national referral centre for paediatric CD. A case-matched analysis was conducted on two cohorts matched for age, gender, disease location, disease behaviour and disease activity, who received CS or EEN as their initial treatment. Subsequently, cohort analysis was conducted on all patients who undertook a course of EEN therapy between 2004 and 2013.

Results:

The case-matched analysis found higher remission rates after treatment with EEN (24/28, 86%) compared with those with CS (15/28, 54%; P=0.02). Dietetic contacts were found to be pivotal to the success of treatment and the attainment of remission. In total, 59 patients completed EEN at some time-point in their disease course and were included in the cohort analysis. Sixty-nine per cent of this cohort entered clinical remission (41/59). EEN was found to be most effective when used as an initial treatment (P=0.004) and less effective in patients aged under 10 years (P=0.04).

Conclusions:

EEN should be strongly considered as a favourable primary treatment over CS, especially in those diagnosed over the age of 10 years.

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Acknowledgements

We thank the following for their support and assistance in completing this study: Mary Hamzawi, Siobhain Kiernan, Karen O’ Driscoll, Prof. Billy Bourke, Dr Annemarie Broderick, Dr Shoana Quinn, Dr Michael Mc Dermott, Prof Maureen O’Sullivan and the DOCHAS study project. LL and MT are students from Dublin Institute of Technology and Trinity College Dublin. AC is funded by the National Children’s Research Centre as part of the DOCHAS study.

Author contributions

Study concept and design: SH, AC, MH and SS. Data collection and analysis: MT, LL and AC. Manuscript drafting: all authors. Study guarantor: SH.

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Author notes

  1. L Lafferty and M Tuohy: These authors contributed equally to this work.

Authors and Affiliations

  1. Dublin Institute of Technology, Dublin, Ireland

    L Lafferty, M Tuohy & S Sugrue

  2. National Centre for Paediatric Gastroenterology (NCPG), Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland

    L Lafferty, M Tuohy, A Carey, M Hurley & S Hussey

  3. National Children’s Research Centre, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland

    A Carey & S Hussey

  4. Academic Centre for Paediatric Research, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland

    S Hussey

  5. Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland

    S Hussey

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  1. L Lafferty
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Correspondence to S Hussey.

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Lafferty, L., Tuohy, M., Carey, A. et al. Outcomes of exclusive enteral nutrition in paediatric Crohn’s disease. Eur J Clin Nutr 71, 185–191 (2017). https://doi.org/10.1038/ejcn.2016.210

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