Disabled Traveler: Severe Crohn's Disease In Children: Feeding Tube (Bypassing Normal GI Route) For Two months Shown To Be as Efficacious as Corticosteroids

Tuesday, June 5, 2012

Severe Crohn's Disease In Children: Feeding Tube (Bypassing Normal GI Route) For Two months Shown To Be as Efficacious as Corticosteroids

For children with severe cases of Crohn's disease , corticosteroids and disease modifying drugs are often used, since it is an inflammatory auto-immune disease.

An other possible approach is enteral feeding through a feeding tube, technically called Exclusive Enteral Nutrition (EEN). The treatment has been found to be as efficacious as corticosteroids [1].

However, there are many other treatments options such as aminosalicylates ; immuno-suppressive and biologic drugs, as described in a New York Times article [2]. Note the absence of EEN in the NYT list. EEN needs to be compared to those, too.

The children were fed a formula which may contain whole proteins (polymeric) or modified proteins (e.g. elemental).

The success rate has been rather good:

"…Twelve of 15 (80%) newly diagnosed CD and seven of 12 (58%) with long-standing disease entered remission…"

Two issues :

1. The child has to be fed through a feeding tube for 8 weeks [1]
2. Besides the discomfort, the methods has some risks, namely , pneumonia and aspiration [4]

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Enteral Food Against Crohn's Disease

Exactly why the treatment works is not fully understood, quoting [2], the possible mechanisms are:

* reduced gut activity due to the administration of a solely liquid diet,
* indirect nutritional effects,
* direct anti-inflammatory effects,
* via modulation of the gastrointestinal microflora.

_**Talk to your Doctor**_

_**Sources:**_

1. [Journal of Gastroenterology and Hepatology][3]. ; "Exclusive enteral feeding as primary therapy for Crohn's disease in Australian children and adolescents: a feasible and effective approach." ;2006
2. [New York Times][4] ;
3. [Digestive Diseases and Sciences.][5] ; "Longer-Term Outcomes of Nutritional Management of Crohn's Disease in Children." ; 2012
4. INFLAMMATORY BOWEL DISEASE: A PRACTICAL APPROACH, SERIES #51; Seymour Katz, M.D., Series Editor;PRACTICAL GASTROENTEROLOGY • APRIL 2009
5. [Practical Gastroenterology][6]," Aspiration Risk and Enteral Feeding: A Clinical Approach" ; 2003

Technorati Tags: [biologic drugs][7], [Children][8], [corticosteroids][9], [Crohn's disease][10], [EEN][11], [Enteral Feeding][12], [Enteral formulas][13], [immuno-suppressive drugs][14], [Pediatrics][15], [remission][16]

URL: http://www.medinewsdigest.com/?p=4725

Tuesday, June 5, 2012

Severe Crohn's Disease In Children: Feeding Tube (Bypassing Normal GI Route) For Two months Shown To Be as Efficacious as Corticosteroids

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