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P284. Nutrition status clinical assessment in children with moderate to severe Crohn's disease treated with total enteral nutrition (TEN)

J. Kierkus, M. Szczepanski, P. Socha, J. Socha, J. Ryzko

The Children's Memorial Health Institute, Warsaw, Poland

Rationale: Growth retardation and malnutrition is very common complications of Crohn's disease in children. Total enteral nutrition (TEN) with a liquid formula can suppress gut inflammation, induce remission and improved growth in active Crohn's disease. To characterise the nutrition status before and after 6 weeks TEN in children with moderate to severe Crohn's disease.

Methods: Twenty children with Crohn's were recruited. They all had at least moderately active disease with Pediatric Crohn's disease activity index (PCDAI) of >30. All patients were placed on an total enteral nutrition regiment with Nutrison Standard (Nutricia) in hospital and next at home. TEN was continue 6 weeks, each infused 1400–2200 ml. This provided approximately 50 kcal/kg/day. Only clear water were allowed orally for this 6 weeks period. Each child was assessed at the time of recruitment and after six weeks of TEN (14 children), or sooner if withdrawn early from the study (6 children). Clinical assessment (PCDAI), anthropometric measurements (weight; height; skinfolds for LBM: biceps, triceps, subscapular and suprailiac). Laboratory blood investigations included full blood count and plateles, erythrocyte, sedimentation rate (ESR), C reactive protein (CRP), and serum albumin.

Results: Based on intention to treat analysis, remission (PCDAI < 10) was achieved in 40% patient's (8/20). There was a significant increase in weight, weight for height SDS, LBM (p < 0.05). Change in nutrition parameters after 6 weeks TEN: weight (kg) +5.7; weight for height SDS +0.6; LBM (kg) +4.8. For laboratory parameters were observed significant rise in haemoglobin, erythrocytes and significant reduction in platelet and CRP. No significant change in ESR and albumin.

Conclusion: TEN suppresses inflammation and improves nutrition status in active Crohn's disease in children.