Nutrients, Vol. 17, Pages 3124: Enteral Nutrition in Pediatric Crohn’s Disease: New Perspectives
Nutrients doi: 10.3390/nu17193124
Authors:
Viviana Fara Brindicci
Rosangela Grieco
Roberta Giusy Ruiz
Sabrina Cardile
Teresa Capriati
Chiara Maria Trovato
Giulia Bolasco
Daniela Knafelz
Fiammetta Bracci
Arianna Alterio
Francesca Ferretti
Domenica Elia
Elena Spinetti
Ruggiero Francavilla
Antonella Diamanti
Background/Objectives: The efficacy of exclusive enteral nutrition (EEN) on the induction of remission of Crohn’s disease (CD) has been demonstrated with different diets (elemental, semi-elemental, and polymeric). A narrative review was conducted to assess the effects of different enteral diets in pediatric CD patients, considering the hypothesis that manipulating the nutritional key ingredients may enhance the clinical efficacy. Methods: An extensive literature search was performed across PubMed, Embase, and the Cochrane Library, covering all records published up to 27 July 2025. Both pediatric and adult studies were considered, and nutritional composition was compared with remission rates. Results: Twelve studies involving patients with active CD treated with EEN were found. Most studies were conducted with polymeric diets (n = 8), which achieved a high remission rate (up to 85%), thus confirming their advantage over other EEN diets. Conclusions: EEN with polymeric diets satisfies the need to revert the acute inflammation in most pediatric CD patients. Polymeric formulas have two advantages: (a) they contain transforming growth factor-β (TGF-β), which exerts anti-inflammatory effects on intestinal epithelial cells, and (b) they have a mixed-fat composition, including saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs) as well medium-chain triglycerides (MCTs), which provides better results than EEN diets enriched with single-fat components. However, pathophysiological evidence shows gut microbiota alterations after EEN begins, despite clinical improvement. So, a potential strategy to enhance the efficacy of polymeric diets may be fiber enrichment.
Background/Objectives: The efficacy of exclusive enteral nutrition (EEN) on the induction of remission of Crohn’s disease (CD) has been demonstrated with different diets (elemental, semi-elemental, and polymeric). A narrative review was conducted to assess the effects of different enteral diets in pediatric CD patients, considering the hypothesis that manipulating the nutritional key ingredients may enhance the clinical efficacy. Methods: An extensive literature search was performed across PubMed, Embase, and the Cochrane Library, covering all records published up to 27 July 2025. Both pediatric and adult studies were considered, and nutritional composition was compared with remission rates. Results: Twelve studies involving patients with active CD treated with EEN were found. Most studies were conducted with polymeric diets (n = 8), which achieved a high remission rate (up to 85%), thus confirming their advantage over other EEN diets. Conclusions: EEN with polymeric diets satisfies the need to revert the acute inflammation in most pediatric CD patients. Polymeric formulas have two advantages: (a) they contain transforming growth factor-β (TGF-β), which exerts anti-inflammatory effects on intestinal epithelial cells, and (b) they have a mixed-fat composition, including saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs) as well medium-chain triglycerides (MCTs), which provides better results than EEN diets enriched with single-fat components. However, pathophysiological evidence shows gut microbiota alterations after EEN begins, despite clinical improvement. So, a potential strategy to enhance the efficacy of polymeric diets may be fiber enrichment. Read More