Effect of Exclusive Enteral Nutrition on the Disease Process, Nutrition Status, and Gastrointestinal Microbiota for Chinese Children With Crohn's Disease. Issue 4 (3rd July 2020)

• Record Type: Journal Article
• Authors: Tang, Wenjuan; Huang, Ying; Shi, Peng; Wang, Yuhuan; Zhang, Ye; Xue, Aijuna; Tang, Zifei; Hu, Wenhui; Sun, Hua; Zhang, Ping; Zheng, Cuifang; Shi, Jieru; Wang, Shengnan; Qiu, Xiaoxia; Lu, Xiaolan; Miao, Shijian; Meng, Yingying
• Is Part Of: JPEN, Journal of parenteral and enteral nutrition. Volume 45:Issue 4(2021)
• Page Start: 826
• Page End: 838
• Publication Date: 2020-07-03
• Subjects: exclusive enteral nutrition -- microbiome -- pediatrics -- Chinese; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; 615.85484
• DOI: 10.1002/jpen.1938
• Languages: English
• ISSNs: 0148-6071

Abstract

Abstract: Background: The aim of this study was to prospectively study the effect of exclusive enteral nutrition (EEN) treatment on Chinese pediatric Crohn's disease (CD) patients. Methods: Thirty‐one newly diagnosed CD patients were enrolled in this study and treated with EEN for 8 weeks. Twelve healthy controls (HCs) donated their fecal samples. Statistical methods were used to compare the differences. Results: According to the Simple Endoscopic Score for CD (SES‐CD) at the end of the EEN treatment, 21 patients with SES‐CD ≤4 were classified into the remission group (CD‐RE), and 10 patients with SES‐CD >4 were classified into the nonremission group (CD‐NRE). After EEN therapy, there was a significant decrease in the SES‐CD, the weighted Pediatric Crohn's Disease Activity Index (wPCDAI), and fecal calprotectin (FCP) in the CD‐RE group (all P < .001). The wPCDAI and FCP also decreased in the CD‐NRE group (both P < .05). In terms of nutrition improvement, the CD‐RE group patients showed more improvement in weight gain, hemoglobin, and serum albumin level than the CD‐NRE group patients (all P < .05). For the microbiota, the CD patients had a lower bacterial diversity and different bacterial community compared with HCs. EEN increased overall diversity and was able to shift the dysbiosis in CD patients toward a healthier state. Absence of improvement in wPCDAI and Shannon index at 2 weeks predicts poor response at the end of EEN. Conclusion: EEN can be used in most Chinese pediatric CD patients to induce remission and improve nutrition.