Enteral feeding in inflammatory bowel disease
- 1 May 2006
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Clinical Nutrition and Metabolic Care
- Vol. 9 (3), 314-318
- https://doi.org/10.1097/01.mco.0000222117.76536.49
Abstract
Treatment algorithms for inflammatory bowel disease are changing rapidly. Increased and earlier use of immunomodulatory drugs and availability of biologic agents have reduced dependence on corticosteroids and made mucosal healing a realistic goal. It is timely to debate the role of enteral nutrition in this evolving therapeutic armamentarium for Crohn's disease, and to examine the mechanisms of its anti-inflammatory effects in light of current understanding of disease pathogenesis. Clinical studies have suggested that response to enteral nutrition is associated with decreased mucosal inflammation in Crohn's disease, that isolated Crohn's colitis is less responsive and that exclusive enteral nutrition is required. Basic research has demonstrated that lipids in the intestinal lumen can alter signalling of the mucosal immune system by intestinal epithelial cells. Exclusive enteral nutrition is associated with alteration of enteric microflora. Enteral nutrition is an efficacious treatment of active inflammation involving the ileum; recent-onset disease may be particularly responsive. The significance of effects on enteric flora deserves further exploration in view of the importance of microbes to disease pathogenesis.Keywords
This publication has 24 references indexed in Scilit:
- Long-term outcome of nutritional therapy in paediatric Crohn's diseaseClinical Nutrition, 2005
- Colonic Crohn’s Disease in Children Does Not Respond Well to Treatment with Enteral Nutrition If the Ileum Is Not InvolvedDigestive Diseases and Sciences, 2005
- Enteral Nutrition in the Management of Crohn's DiseaseJournal of Parenteral and Enteral Nutrition, 2005
- Can We Alter The Natural History Of Crohn Disease In Children?Journal of Pediatric Gastroenterology and Nutrition, 2005
- Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s diseaseGastroenterology, 2004
- Consensus and Controversy in the Management of Pediatric Crohn Disease: An International SurveyJournal of Pediatric Gastroenterology and Nutrition, 2003
- Enteral Nutrition and Corticosteroids in the Treatment of Acute Crohn's Disease in ChildrenJournal of Pediatric Gastroenterology and Nutrition, 2000
- Mucosal healing and a fall in mucosal pro‐inflammatory cytokine mRNA induced by a specific oral polymeric diet in paediatric Crohn’s diseaseAlimentary Pharmacology & Therapeutics, 2000
- Meta-analysis of enteral nutrition as a primary treatment of active crohn's diseaseGastroenterology, 1995
- Clinical, biological, and endoscopic picture of attacks of Crohn's diseaseGastroenterology, 1990