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Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift

Di Caro, S; Fragkos, KC; Keetarut, K; Koo, HF; Sebepos-Rogers, G; Saravanapavan, H; Barragry, J; ... Rahman, F; + view all (2019) Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift. Nutrients , 11 (9) , Article 2222. 10.3390/nu11092222. Green open access

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Abstract

Medical and surgical treatments for Crohn’s disease are associated with toxic effects. Medical therapy aims for mucosal healing and is achievable with biologics, immunosuppressive therapy, and specialised enteral nutrition, but not with corticosteroids. Sustained remission remains a therapeutic challenge. Enteral nutrition, containing macro- and micro-nutrients, is nutritionally complete, and is provided in powder or liquid form. Enteral nutrition is a low-risk and minimally invasive therapy. It is well-established and recommended as first line induction therapy in paediatric Crohn’s disease with remission rates of up to 80%. Other than in Japan, enteral nutrition is not routinely used in the adult population among Western countries, mainly due to unpalatable formulations which lead to poor compliance. This study aims to offer a comprehensive review of available enteral nutrition formulations and the literature supporting the use and mechanisms of action of enteral nutrition in adult Crohn’s disease patients, in order to support clinicians in real world decision-making when offering/accepting treatment. The mechanisms of actions of enteral feed, including their impact on the gut microbiome, were explored. Barriers to the use of enteral nutrition, such as compliance and the route of administration, were considered. All available enteral preparations have been comprehensively described as a practical guide for clinical use. Likewise, guidelines are reported and discussed.

Type: Article
Title: Enteral Nutrition in Adult Crohn’s Disease: Toward a Paradigm Shift
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3390/nu11092222
Publisher version: https://doi.org/10.3390/nu11092222
Language: English
Additional information: © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Keywords: enteral nutrition; Crohn’s disease; exclusive enteral nutrition; partial enteral nutrition
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Microbial Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10083480
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