Nutrition

Exclusive enteral nutrition is an effective therapy with remission of the disease seen in 60-80% of children with small and large bowel disease (1).

It can be either polymeric or elemental feeds

• there is no significant difference in the efficacy between the two feeds
• polymeric feeds may be more palatable
• naso-gastric tube or gastrostomy can be used to administer the feeds (1)

The mainstay of the nutritional management of the child with Crohn's disease is an elemental diet with the exclusion of all other foods, which can induce remission in up to 80% of patients. In small bowel disease it is said to be as effective as steroids.

The diet aims to provide 150 Kcal per day if there is growth failure.

Duration of treatment is usually six weeks and reintroduction of food can be done cautiously over 1-3 weeks depending on the patient symptoms whilst weaning the enteral feed (1).

Reference:

• (1) British Society of Paediatrics Gastroenterology Hepatology and Nutrition (BSPGHAN) 2008. Guidelines for the Management of Inflammatory Bowel Disease (IBD) in Children in the United Kingdom