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- Title
Longer-Term Outcomes of Nutritional Management of Crohn's Disease in Children.
- Authors
Lambert, B.; Lemberg, D.; Leach, S.; Day, A.
- Abstract
Background: While the short-term benefits of exclusive enteral nutrition (EEN) for induction of remission in children with Crohn's disease (CD) are well documented, the longer-term outcomes are less clear. Aim: This retrospective study aimed to ascertain the outcomes for up to 24 months following EEN in a group of children with CD. Methods: Children treated with EEN as initial therapy for newly diagnosed CD over a 5-year period were identified. Details of disease activity, growth, and drug requirements over the period of follow-up were noted. Outcomes in children managed with EEN were compared to a group of children initially treated with corticosteroids. Results: Over this time period, 31 children were treated with EEN and 26 with corticosteroids. Twenty-six (84 %) of the 31 children treated with EEN entered remission. Children treated with EEN exhibited lower pediatric Crohn's disease activity index (PCDAI) scores at 6 months ( p = 0.02) and received lower cumulative doses of steroids over the study period ( p < 0.0001) than the group treated with corticosteroids. Height increments over 24 months were greater in the EEN group ( p = 0.01). Although the median times to relapse were the same, the EEN group had a lower incidence of relapse in each time interval and survival curve analysis showed lower risk of relapse ( p = 0.008). Conclusions: EEN lead to multiple benefits beyond the initial period of inducing remission for these children, with positive outcomes over 2 years from diagnosis. Of particular clinical relevance to growing children was the reduced exposure to corticosteroids.
- Subjects
CROHN'S disease in children; CHILD nutrition; DIET therapy; ADRENOCORTICAL hormones; DISEASE remission; RETROSPECTIVE studies; HEALTH outcome assessment; THERAPEUTICS
- Publication
Digestive Diseases & Sciences, 2012, Vol 57, Issue 8, p2171
- ISSN
0163-2116
- Publication type
Article
- DOI
10.1007/s10620-012-2232-2