title: Use of exclusive enteral nutrition in adults with Crohn's disease: a review.
abstract: Exclusive enteral nutrition (EEN) is well-established as a first line therapy instead of corticosteroid (CS) therapy to treat active Crohn's disease (CD) in children. It also has been shown to have benefits over and above induction of disease remission in paediatric populations. However, other than in Japanese populations, this intervention is not routinely utilised in adults. To investigate potential reasons for variation in response between adult studies of EEN and CS therapy. The Ovid database was searched over a 6-mo period. Articles directly comparing EEN and CS therapy in adults were included. Eleven articles were identified. EEN therapy remission rates varied considerably. Poor compliance with EEN therapy due to unpalatable formula was an issue in half of the studies. Remission rates of studies that only included patients with previously untreated/new CD were higher than studies including patients with both existing and new disease. There was limited evidence to determine if disease location, duration of disease or age of diagnosis affected EEN therapy outcomes. There is some evidence to support the use of EEN as a treatment option for a select group of adults, namely those motivated to adhere to an EEN regimen and possibly those newly diagnosed with CD. In addition, the use of more palatable formulas could improve treatment compliance.
authors.affiliation: Catherine L Wall, Andrew S Day, Department of Paediatrics, University of Otago, Christchurch 8140, New Zealand.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Wall
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Day
authors.forename: Richard B
authors.initials: RB
authors.lastname: Gearry
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003424:Crohn Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004750:Enteral Nutrition; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009752:Nutritional Status; D010349:Patient Compliance; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents
keywords: Adults; Crohn’s disease; Exclusive enteral nutrition