Induction Therapy with Exclusive Enteral Nutrition - Barriers to Success

Nutrition modulation – is it worth it for Crohn’s Disease patients?

Exclusive enteral nutrition (EEN) is recommended as first line therapy to induce remission in children with active luminal Crohn’s Disease. Partial enteral nutrition (PEN) should not be used for induction of remission. EEN has been shown to be very efficacious and thus why a majority of physicians agree to use it as first line therapy. Compared to the use of steroids which is equally potent, EEN assists the healing of the mucosal lining. In the pediatric field, both EN and steroids are both as potent.

In Crohn’s disease because of the irritation to the mucosa growth, retardation is common and once a patient has growth retardation it is very hard to catch up, most never have catch up growth. In clinical settings there are many barriers and enablers to EEN such as the internal health system including nurses, dietitians, social workers, space for teaching, as well as the external health system influences it allowing for funding for supplies, coverage for EEN supplies and formula etc. In conclusion there are many aspects of the disease and therapy that must be investigated in order to ameliorate the care given to patients living with CD.