Enteral nutrition improves malnutrition and disease status in pediatric IBD
20 December 2021
2 minutes to read
Source / Disclosures
Stoner NL. The impact of nutritional intervention in very early onset inflammatory bowel disease. Presented at the annual meeting of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition; December 12-18, 2021 (virtual meeting).
Disclosures: Stoner reports support from the CPNP Nutrition Research Grant.
According to a speaker, a proprietary enteral nutrition intervention improved malnutrition and disease status in pediatric patients with very early inflammatory bowel disease.
“Children with very early-onset IBD (VEO) suffer from devastating complications, including malnutrition, stunted growth and nutritional deficiencies, which are often present at diagnosis; there is a higher risk of poor oral intake and immune-mediated disease in the very early onset group ”, Natalie L. Stoner, RD, CSP, LDN, Outpatient Clinical Dietitian of the Center for Pediatric Inflammatory Bowel Disease, Center for Pediatric Inflammatory Bowel Disease, Center for Pediatric Inflammatory Bowel Disease at the Children’s Hospital of Philadelphia, said at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition. “Due to the often refractory nature of VEO-IBD, synergistic therapeutic strategies are required. Nutritional support is one such approach.
To determine whether proprietary enteral nutrition therapy (EEN) improves the ability to elicit a response, Stoner and colleagues conducted a prospective observational study of 38 malnourished pediatric patients aged 13 months to 6 years with VEO-IBD. They further compared patients who underwent a NEA (n = 19) with controls who underwent an operation without a NEA (n = 19) and recorded a change in malnutrition status and clinical activity of the patient. illness at baseline and at 12 weeks. The treatment regimen included 80% of the estimated caloric needs of infant formula and 20% of the estimated caloric needs of an anti-inflammatory diet administered by nasogastric tube, oral ingestion, or a combination of the two.
Compared to baseline, patients who underwent EEN treatment saw improvement in severity of malnutrition (mild: 58% vs. 10%; moderate: 16% vs. 0%; severe: 26% vs. 11% ); at the end of the study, 79% of the patients were no longer malnourished. Controls who underwent an operation without NEC also observed an improvement in the severity of malnutrition (mild: 42% vs. 26%; moderate: 16% vs. 10%; severe: 42% vs. 11%); 53% have achieved non-malnourished status. Further assessment of both groups gave an increased percentage of total fat, total dietary fiber, carbohydrate, and calorie intake. Stoner also noted an improvement at 12 weeks in the percentages of iron, vitamin D and calcium.
“Malnutrition is a huge problem in newly diagnosed patients with very early-onset IBD and can have a huge impact on our treatment responses. Both EEN and non-EEN nutrition interventions can be effective in improving malnutrition and ultimately disease status, ”Stoner concluded. “Then we really hope to look at the data to create pilot data to understand micronutrient deficiencies and develop screening guidelines in the VEO-IBD population. … Large-scale, prospective studies are essential to guide treatment decisions and identify patients who may benefit from NEA.