Switching off Inflammation with Diet: A Review of Exclusive Enteral Nutrition in Children with Crohn’s Disease

Abstract

The specific dietary intervention known as exclusive enteral nutrition (EEN) is well-established as the preferred treatment to induce remission in children with active Crohn’s disease. The majority of children managed with EEN respond well to this intervention, with high rates of mucosal healing, improved nutrition, and enhanced bone health, with few side effects. This dietary therapy, utilising a complete nutritional liquid product, is generally well-tolerated over the short period of induction of remission, but does require substantial changes to routine oral intake and daily patterns. After a period of exclusive use of this therapy, ongoing use of the same formulae (as maintenance enteral nutrition) may prolong remission and prevent relapse. Over the last few years, new reports have advanced our understanding of the mechanisms by which EEN acts: these include modulation of the intestinal microbiota and direct anti-inflammatory effects upon the epithelium. This review highlights key outcomes of EEN in children with Crohn’s disease and highlights the current understanding of the mechanisms of action.