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Published in: BMC Gastroenterology 1/2017

Open Access 01-12-2017 | Research article

Dietary treatment of Crohn’s disease: perceptions of families with children treated by exclusive enteral nutrition, a questionnaire survey

Authors: Vaios Svolos, Konstantinos Gerasimidis, Elaine Buchanan, Lee Curtis, Vikki Garrick, Jacqueline Hay, Susan Laird, Joanna Munro, Daniel R. Gaya, Richard K. Russell, Richard Hansen

Published in: BMC Gastroenterology | Issue 1/2017

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Abstract

Background

Diet is strongly associated with the aetiology of Crohn’s Disease (CD) and exclusive enteral nutrition (EEN) is the primary induction treatment in paediatric CD. This study explored opinions around the use of EEN and alternative novel, solid food-based diets (SFDs) expressed by paediatric patients with CD, previously treated with EEN and their parents.

Methods

This anonymous questionnaire surveyed families of CD patients treated with EEN over 1 year. Two questionnaire forms were completed; one asking the patients’ opinions and another referring to their main carer. This questionnaire explored participants’ demographic characteristics; acceptability of a repeat EEN course to treat a future flare (EEN repeat); their opinion on how difficult EEN would be compared to an example SFD; and their intention to participate in a future clinical trial assessing the therapeutic efficacy of an SFD in CD.

Results

Forty-one families of CD patients were approached with 29 sending replies (71%). Most of our participants were positive on completing another EEN course, however the majority would choose an SFD alternative (Patients:66, Parents:72%). Both patients and their parents rated EEN to be more difficult to adhere to compared to an example SFD (p < 0.05), and their ratings were strongly correlated (EEN:r = 0.83, SFD:r = 0.75, p < 0.001). The majority of our respondents would agree to participate in a clinical trial assessing an SFD’s effectiveness (Patients:79, Parents:72%) for the management of active CD.

Conclusions

While patients with CD and their families would accept an EEN repeat, the majority would prefer an SFD alternative. CD families surveyed are supportive of the development of solid food-based dietary treatments.
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Literature
3.
go back to reference Ruemmele FM, Veres G, Kolho KL, Griffiths A, Levine A, Escher JC, Amil Dias J, Barabino A, Braegger CP, Bronsky J, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J crohns colitis. 2014;8(10):1179–207.CrossRefPubMed Ruemmele FM, Veres G, Kolho KL, Griffiths A, Levine A, Escher JC, Amil Dias J, Barabino A, Braegger CP, Bronsky J, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J crohns colitis. 2014;8(10):1179–207.CrossRefPubMed
4.
go back to reference Wall CL, Day AS, Gearry RB. Use of exclusive enteral nutrition in adults with Crohn’s disease: a review. World j gastroenterol. 2013;19(43):7652–60.CrossRefPubMedPubMedCentral Wall CL, Day AS, Gearry RB. Use of exclusive enteral nutrition in adults with Crohn’s disease: a review. World j gastroenterol. 2013;19(43):7652–60.CrossRefPubMedPubMedCentral
6.
go back to reference Gerasimidis K, Mcgrogan P, Hassan K, Edwards CA. Dietary modifications, nutritional supplements and alternative medicine in paediatric patients with inflammatory bowel disease. Aliment pharmacol ther. 2008;27(2):155–65.CrossRefPubMed Gerasimidis K, Mcgrogan P, Hassan K, Edwards CA. Dietary modifications, nutritional supplements and alternative medicine in paediatric patients with inflammatory bowel disease. Aliment pharmacol ther. 2008;27(2):155–65.CrossRefPubMed
7.
go back to reference Brotherton CS, Taylor AG, Bourguignon C, Anderson JG. A high-fiber diet may improve bowel function and health-related quality of life in patients with Crohn disease. Gastroenterol nurs. 2014;37(3):206–16.CrossRefPubMedPubMedCentral Brotherton CS, Taylor AG, Bourguignon C, Anderson JG. A high-fiber diet may improve bowel function and health-related quality of life in patients with Crohn disease. Gastroenterol nurs. 2014;37(3):206–16.CrossRefPubMedPubMedCentral
8.
go back to reference Olendzki BC, Silverstein TD, Persuitte GM, Ma Y, Baldwin KR, Cave D. An anti-inflammatory diet as treatment for inflammatory bowel disease: a case series report. Nutr j. 2014;13:5.CrossRefPubMedPubMedCentral Olendzki BC, Silverstein TD, Persuitte GM, Ma Y, Baldwin KR, Cave D. An anti-inflammatory diet as treatment for inflammatory bowel disease: a case series report. Nutr j. 2014;13:5.CrossRefPubMedPubMedCentral
9.
go back to reference Rajendran N, Kumar D. Food-specific IgG4-guided exclusion diets improve symptoms in Crohn’s disease: a pilot study. Colorectal dis. 2011;13(9):1009–13.CrossRefPubMed Rajendran N, Kumar D. Food-specific IgG4-guided exclusion diets improve symptoms in Crohn’s disease: a pilot study. Colorectal dis. 2011;13(9):1009–13.CrossRefPubMed
10.
go back to reference Obih C, Wahbeh G, Lee D, Braly K, Giefer M, Shaffer ML, Nielson H, Suskind DL. Specific carbohydrate diet for pediatric inflammatory bowel disease in clinical practice within an academic IBD center. Nutrition. 2016;32(4):418–25.CrossRefPubMed Obih C, Wahbeh G, Lee D, Braly K, Giefer M, Shaffer ML, Nielson H, Suskind DL. Specific carbohydrate diet for pediatric inflammatory bowel disease in clinical practice within an academic IBD center. Nutrition. 2016;32(4):418–25.CrossRefPubMed
11.
go back to reference Prince AC, Myers CE, Joyce T, Irving P, Lomer M, Whelan K. Fermentable carbohydrate restriction (Low FODMAP diet) in clinical practice improves functional gastrointestinal symptoms in patients with inflammatory bowel disease. Inflamm bowel dis. 2016;22(5):1129–36.CrossRefPubMed Prince AC, Myers CE, Joyce T, Irving P, Lomer M, Whelan K. Fermentable carbohydrate restriction (Low FODMAP diet) in clinical practice improves functional gastrointestinal symptoms in patients with inflammatory bowel disease. Inflamm bowel dis. 2016;22(5):1129–36.CrossRefPubMed
12.
go back to reference Sigall-Boneh R, Pfeffer-Gik T, Segal I, Zangen T, Boaz M, Levine A. Partial enteral nutrition with a Crohn’s disease exclusion diet is effective for induction of remission in children and young adults with Crohn’s disease. Inflamm bowel dis. 2014;20(8):1353–60.CrossRefPubMed Sigall-Boneh R, Pfeffer-Gik T, Segal I, Zangen T, Boaz M, Levine A. Partial enteral nutrition with a Crohn’s disease exclusion diet is effective for induction of remission in children and young adults with Crohn’s disease. Inflamm bowel dis. 2014;20(8):1353–60.CrossRefPubMed
13.
go back to reference Hwang C, Ross V, Mahadevan U. Popular exclusionary diets for inflammatory bowel disease: the search for a dietary culprit. Inflamm bowel dis. 2014;20(4):732–41.CrossRefPubMed Hwang C, Ross V, Mahadevan U. Popular exclusionary diets for inflammatory bowel disease: the search for a dietary culprit. Inflamm bowel dis. 2014;20(4):732–41.CrossRefPubMed
14.
go back to reference Buchanan E, Gaunt WW, Cardigan T, Garrick V, Mcgrogan P, Russell RK. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment pharmacol ther. 2009;30(5):501–7.CrossRefPubMed Buchanan E, Gaunt WW, Cardigan T, Garrick V, Mcgrogan P, Russell RK. The use of exclusive enteral nutrition for induction of remission in children with Crohn’s disease demonstrates that disease phenotype does not influence clinical remission. Aliment pharmacol ther. 2009;30(5):501–7.CrossRefPubMed
15.
go back to reference Kansal S, Wagner J, Kirkwood CD, Catto-Smith AG. Enteral nutrition in Crohn’s disease: an underused therapy. Gastroenterol res pract. 2013;2013:482108.CrossRefPubMedPubMedCentral Kansal S, Wagner J, Kirkwood CD, Catto-Smith AG. Enteral nutrition in Crohn’s disease: an underused therapy. Gastroenterol res pract. 2013;2013:482108.CrossRefPubMedPubMedCentral
16.
go back to reference Rodrigues AF, Johnson T, Davies P, Murphy MS. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn’s disease? Arch dis child. 2007;92(9):767–70.CrossRefPubMedPubMedCentral Rodrigues AF, Johnson T, Davies P, Murphy MS. Does polymeric formula improve adherence to liquid diet therapy in children with active Crohn’s disease? Arch dis child. 2007;92(9):767–70.CrossRefPubMedPubMedCentral
17.
go back to reference Limdi JK, Aggarwal D, McLaughlin JT. Dietary practices and beliefs in patients with inflammatory bowel disease. Inflamm bowel dis. 2016;22(1):164–70.CrossRefPubMed Limdi JK, Aggarwal D, McLaughlin JT. Dietary practices and beliefs in patients with inflammatory bowel disease. Inflamm bowel dis. 2016;22(1):164–70.CrossRefPubMed
18.
go back to reference Zallot C, Quilliot D, Chevaux JB, Peyrin-Biroulet C, Gueant-Rodriguez RM, Freling E, Collet-Fenetrier B, Williet N, Ziegler O, Bigard MA, et al. Dietary beliefs and behavior among inflammatory bowel disease patients. Inflamm bowel dis. 2013;19(1):66–72.CrossRefPubMed Zallot C, Quilliot D, Chevaux JB, Peyrin-Biroulet C, Gueant-Rodriguez RM, Freling E, Collet-Fenetrier B, Williet N, Ziegler O, Bigard MA, et al. Dietary beliefs and behavior among inflammatory bowel disease patients. Inflamm bowel dis. 2013;19(1):66–72.CrossRefPubMed
19.
go back to reference le Coq EM, Boeke AJ, Bezemer PD, Colland VT, van Eijk JT. Which source should we use to measure quality of life in children with asthma: the children themselves or their parents? Qual life res int j qual life aspects treat care rehabil. 2000;9(6):625–36.CrossRef le Coq EM, Boeke AJ, Bezemer PD, Colland VT, van Eijk JT. Which source should we use to measure quality of life in children with asthma: the children themselves or their parents? Qual life res int j qual life aspects treat care rehabil. 2000;9(6):625–36.CrossRef
20.
go back to reference Eiser C, Morse R. Can parents rate their child’s health-related quality of life? results of a systematic review. Qual life res int j qual life aspects treat care rehabil. 2001;10(4):347–57.CrossRef Eiser C, Morse R. Can parents rate their child’s health-related quality of life? results of a systematic review. Qual life res int j qual life aspects treat care rehabil. 2001;10(4):347–57.CrossRef
21.
go back to reference Dignass A, Van Assche G, Lindsay JO, Lemann M, Soderholm J, Colombel JF, Danese S, D’Hoore A, Gassull M, Gomollon F, et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: current management. J crohns colitis. 2010;4(1):28–62.CrossRefPubMed Dignass A, Van Assche G, Lindsay JO, Lemann M, Soderholm J, Colombel JF, Danese S, D’Hoore A, Gassull M, Gomollon F, et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: current management. J crohns colitis. 2010;4(1):28–62.CrossRefPubMed
22.
go back to reference Lichtenstein GR, Hanauer SB, Sandborn WJ. Management of Crohn’s disease in adults. Am j gastroenterol. 2009;104(2):465–83. quiz 464, 484.CrossRefPubMed Lichtenstein GR, Hanauer SB, Sandborn WJ. Management of Crohn’s disease in adults. Am j gastroenterol. 2009;104(2):465–83. quiz 464, 484.CrossRefPubMed
Metadata
Title
Dietary treatment of Crohn’s disease: perceptions of families with children treated by exclusive enteral nutrition, a questionnaire survey
Authors
Vaios Svolos
Konstantinos Gerasimidis
Elaine Buchanan
Lee Curtis
Vikki Garrick
Jacqueline Hay
Susan Laird
Joanna Munro
Daniel R. Gaya
Richard K. Russell
Richard Hansen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2017
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-016-0564-7

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