Naslov
Therapeutic role of enteral nutrition in active paediatric CD: factors associated with failing

Autori
Hojsak, Iva ; Abdović, Slaven ; Mišak, Zrinjka ; Jaklin-Kekez, Alemka, Jadrešin, Oleg ; Kolaček Sanja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
WCPGHAN

Mjesto i datum
Slapovi Iguaçu, Brazil, 08.2008

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
enteral nutrition; chron's disease

Sažetak
Objective: According to present guidelines (1), enteral nutrition could be the first therapeutic choice for the treatment of active disease in paediatric patients with Crohn’ s disease (CD). EN induces remission, corrects malnutrition which is common in children with CD, and has better safety profile compared to steroids. However, data are scarce, and more studies are needed (2). The aim of our study is, therefore, to investigate risk factors associated with failing of EN in paediatric patients with CD. Methods: Data of all newly diagnosed CD patients (n=47) treated in Children’ s Hospital Zagreb from 1997 to 2007 were retrospectively analyzed (27 male and 20 female, age range 9-17.8 years). As a first line therapy for remission induction, EN was introduced in 30 (63, 8 %) of all treated patients. EN consisted of polymeric formula, given exclusively for 5-6 weeks. In all of the patients, either mesalamine (N=8 ; 26, 7%) or azathiprine (N=8 ; 26, 7%) or both (N=16 ; 47, 7%) were concomitantly introduced with the aim of maintaining the remission. Results: Remission was achieved in 21 patients (70%) treated with EN. Once established, duration of remission varied from 4 months to 5 years (mean 17, 6 mo). To explore the risk factors for failing of EN, patients were divided in two groups: group A – patients in which treatment with EN was successful and group B – patients who failed EN. Group A and B differed in: a) Location of disease: ileocolonic disease was present in 100% (group B) vs 28, 57 % (group A) of patients. Disease location for other group A patients was: ileocecal (61, 9%) and ileal disease (9, 52%) ; b) Type of disease (Wiena classification): stricture or stenosis was present in 33, 33% (group B) vs 9, 52% (group A) of patients ; c) Perianal disease was present in 22, 22% (group B) vs 52, 38% (group A) of patients. d) Upper GI disease was present in 11, 11% (group B) vs 28, 57% (group A) of patients. There were no differences in respect to: a) Duration of illness (6 mo vs 6 mo) ; and b) Age at diagnosis (mean 13, 8 y vs 13, 8 y). Conclusion: Predominantly colonic disease was significantly more common in children with CD who failed to achieve remission on EN, while perianal disease and the involvement of upper GI tract were associated with a good therapeutic response to EN.

Izvorni jezik
Engleski

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