title: PRESENT; PREScription of Enteral Nutrition in pediaTric Crohn's disease in Spain.
abstract: OBJECTIVE
  Exclusive enteral nutrition (EEN) is one of the therapeutic strategies used to induce remission in pediatric Crohn's disease (CD). Although its use is recommended in clinical practice guidelines and consensus documents, the frequency of this practice in Spain is unknown.
  
  
  METHODS
  A 70-item questionnaire (
  PREScription of Enteral Nutrition in pediaTric Crohn's disease in Spain) was drafted and distributed through the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition) e-mail list.
  
  
  RESULTS
  We received information from 51 Pediatric Gastroenterology Units. Of the 287 patients newly diagnosed with CD in 2011-2012 at these centres (139 in 2011, 148 in 2012), 182 (63%) received EEN (58% in 2011 and 68% in 2012). 26% of the patients who received EEN in the period studied (64/246) did so during relapses. All the physicians (100%) who responded to the questionnaire believe that EEN is effective in inducing clinical remission in mild to moderate CD. However, 24.5% of respondents never use EEN during relapses. The enteral formulas used most often used were polymeric formulas specific for CD (70.6%) and the preferred administration route was oral, with 60.8% using flavouring and 9.3% allowing a variable percentage of calories in the form of other foods. 65% use 5-ASA together with EEN, 69% use antibiotics and 95% immunomodulators (thiopurines). The duration of EEN tends to be 8 weeks (47.1%), and transition to regular diet was achieved sequentially over a variable period of time. Regarding barriers and limiting factors for the use of EEN, those most frequently reported include lack of acceptance by the patient and/or family (71%), lack of time and/or ancillary staff (69%) and difficulty in convincing the patient and/or family of the suitability of treatment (43%).
  
  
  CONCLUSIONS
  EEN use rates are similar to those of other European questionnaires. Tools that facilitate acceptance by the patient and family are needed. Increasing the time dedicated to this therapeutic modality is likewise important. Given the disparity of criteria for indicating treatment with EEN, it would be useful to have widely accepted clinical practice guidelines or protocols that facilitate the decision to use it.
authors.affiliation: Pediatric Gastroenterology and Nutrition Unit. H Materno. Málaga.. victor.navas@gmail.com.
authors.forename: Victor Manuel
authors.initials: VM
authors.lastname: Navas-López
authors.affiliation: H. Sant Joan de Deu. Barcelona..
authors.forename: Javier
authors.initials: J
authors.lastname: Martín-de-Carpi
authors.affiliation: H. Vall de Hebrón. Barcelona..
authors.forename: Oscar
authors.initials: O
authors.lastname: Segarra
authors.affiliation: Complexo Hospitalario Universitario de Vigo..
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: García-Burriel
authors.affiliation: Hospital Universitario Central de Asturias..
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Díaz-Martín
authors.affiliation: Hospital Universitario Virgen del Rocío. Sevilla..
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Hospital Doce de Octubre. Madrid..
authors.forename: Enrique
authors.initials: E
authors.lastname: Medina
authors.affiliation: Hospital Clínico Universitario San Juan de Alicante. Spain..
authors.forename: Mercedes
authors.initials: M
authors.lastname: Juste
mesh_terms: D002648:Child; D003424:Crohn Disease / Q000453:epidemiology / Q000628:therapy*; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D055656:Prescriptions / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology