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P303. The efficacy of total enteral nutrition in inducing remission and improving nutritional status in children with moderate to severe Crohn's disease


J. Kierkus1, S. Szymanska1, M. Szczepanski1, A. Janowska1, M. Matuszczyk1, E. Szymanska1, J. Ryzko1

1The Children's Memorial Health Institute, Warsaw, Poland



Background: Growth retardation and malnutrition is a very common complication of Crohn's disease (CD) in children. Total enteral nutrition (TEN) is one of a treatment's options in active disease. The aim of this study was to assess the efficacy of TEN for inducing remission in children with active CD in comparison to conventional steroid therapy.

Methods: The study consisted of twenty children with active Crohn's disease. All patients were placed on a TEN regiment in hospital and next at home. It was continue 6 weeks. Children were examined at the time of recruitment and after two weeks of treatment. Those who reached the remission (n = 8) were followed up for next 12 months. Clinical condition, anthropometric measurements and blood tests were analyzed. The control group consisted of 24 children with active CD treated with conventional steroid therapy.

Results: Remission was achieved in 40% of patients on enteral nutrition and 45.8% on steroid therapy, respectively. The duration of remission lasted 7.75±3.2 months in studied group and 8.5±2.48 months in CG, respectively. In both groups duration of remission was 12 months at most. There was a significant increase in weight (+5.7 kg), weight for height SDS (+0.6), and LBM (+4.8 kg) (p < 0.05) in studied group. For laboratory parameters significant rise in haemoglobin, erythrocytes and significant reduction in platelet and CRP was observed. There was no significant change in ESR and albumin. In CG significant change was observed only in CRP.

Conclusions: TEN is an effective treatment for inducing remission in children with active CD, it can suppress gut inflammation and improved growth. Its effectiveness is comparable to conventional steroid therapy.