Exclusive enteral nutrition for induction of remission in pediatric Crohn's disease: Short- and long-term tolerance and acceptance.

Abstract

Objectives: In children with mild to moderate Crohn's disease (CD), exclusive enteral nutrition (EEN) is the first-line treatment. However, adherence to this therapeutic strategy remains challenging because of numerous psychosocial factors. This study aimed to evaluate the short-term acceptability and long-term tolerance of EEN.

Methods: A single-center retrospective study involving a pediatric population with CD was conducted at Robert-Debré Hospital in Paris between December 2023 and March 2024.

Results: Thirty-two patients responded to the questionnaire. developed specifically for this study. It included detailed sections on the EEN received, duration, observed consequences, difficulties encountered by patients and their families, and sociodemographic information. Twenty patients (62%) received oral treatment, while 12 (38%) required a nasogastric tube (NGT). Thirty-eight percent of the patients prematurely discontinued treatment. Most children reported difficulties related to taste, vomiting, and discomfort caused by the NGT. Fifty-nine percent of children would recommend treatment due to its rapid effectiveness, despite the challenges posed by the taste and exclusive nature of the diet. Thirty-two percent of patients reported persistent eating disorders (EDs) long after treatment discontinuation, and 12.5% reported social disorders. Despite strict treatment constraints, children managed to adapt and maintain their daily activities.

Conclusion: EEN has significant benefits for children with CD; however, its acceptability is mixed owing to dietary and social constraints. Adequate dietary and psychological support is crucial for improving adherence to treatment and preventing EDs in one third of our patients after treatment.