Nutrition Therapy and Crohn's Disease

What Is Nutrition Therapy?

Nutrition therapy is a way to treat health conditions or their symptoms with a special diet. Sometimes, nutrition therapy is used instead of standard treatments, such as medicine. A registered dietitian can help create these diets.

Nutrition therapy is also called medical nutrition therapy.

What Is Enteral Nutrition Therapy for Crohn's Disease?

Crohn's disease is a type of inflammatory bowel disease (IBD) that causes inflammation of the intestines. Enteral (EN-tur-ul) nutrition therapy uses a drinkable formula, such as Boost or Pediasure, to control inflammation and promote healing in Crohn's disease.

Why Is Enteral Nutrition Therapy Done for Crohn's Disease?

Enteral nutrition therapy is an alternative to steroids and other medicines that treat the symptoms of Crohn's disease. Steroids can have serious side effects, including poor growth and increased chance of infections.

Enteral nutrition therapy can help improve nutrition and growth, ease inflammation, and heal the gastrointestinal tract (or "gut").

How Does Enteral Nutrition Therapy Work?

The two types of nutrition therapy used to manage Crohn's symptoms are:

• exclusive enteral nutrition (EEN), also called total enteral nutrition (TEN): Formula is used for all meals. Plain water and some other liquids may be allowed.
• partial enteral nutrition (PEN): Some food is allowed along with the formula. This makes the diet easier to follow.

Some kids drink the formula, while others get it through a nasogastric (NG) tube that runs from the nose into the stomach.

Enteral nutrition therapy helps improve nutrition for people with Crohn's disease. But it's not clear why and how it works. Providing balanced nutrition with these formulas might give the gut a chance to heal. It may also work by changing the mix of that live in the gut. Good bacteria in the gut can help protect the intestinal lining and regulate the immune system.

How Long Do People Need Enteral Nutrition Therapy?

Kids with Crohn's disease will need to follow this diet for at least 8–12 weeks. Enteral nutrition therapy can begin at the time of diagnosis or during flare-ups (when symptoms get worse). This is called induction therapy. Its goal is to relieve symptoms.

What Happens After Enteral Nutrition Therapy?

After induction therapy, food is slowly added to the child's diet. The amount of formula decreases as more food is given.

When symptoms are under control, you'll make a plan with your child's doctor to help keep symptoms under control and prevent flare-ups. On maintenance therapy, your child may:

• have a balance of regular food, special diets, and formula
• take maintenance medicines

Your child's doctor and dietitian will help you choose the diet that works best for your child.

Are There Any Risks From Enteral Nutrition Therapy?

Enteral nutrition therapy is very safe. But it can be hard for kids and teens to stick with the diet because:

• They have to drink the same thing every day without much variety. Allowing some food may help to keep kids on the diet.
• The formula might cause stomach upset, vomiting, and diarrhea.

Children with Crohn's disease may become malnourished because:

• belly pain, nausea, and other problems decrease their appetite
• the body needs more calories, especially during flare-ups
• digestion is poor and nutrients aren't absorbed

Not eating enough food or getting enough nutrients from food can lead to poor growth. So doctors check all children with Crohn's disease for malnutrition.

Children with severe malnourishment have shifts in fluids and electrolytes during nutrition therapy. Rarely, this can lead to a problem called refeeding syndrome, which causes:

• irregular heartbeats
• breathing problems
• seizures

To help prevent this, these children get enteral nutrition therapy in a hospital, where the care team can watch them closely.

You also can find more information and support online at:

• The Crohn's and Colitis Foundation
• ImproveCareNow