EXCLUSIVE WHOLE PROTEIN ENTERAL DIET VERSUS PREDNISOLONE IN THE TREATMENT OF ACUTE CROHNS-DISEASE IN CHILDREN

Nineteen children with either newly diagnosed or relapsed Crohn's dise ase were enrolled in a randomized study in which the efficacy of enter al feeding with a whole protein-based formula was compared to high-dos e corticosteroids in achieving clinical remission and normalization of laboratory measurements. Ten children were treated by enteral feeding (Nutrison Standard, Nutricia), and nine received corticosteroids. Bot h treatment regimens lasted 11 weeks. The activity of Crohn's disease was similar in both groups before the commencement of the treatment. C linical symptoms and signs, as judged by the pediatric Crohn's disease activity index and measurements relating to inflammatory activity (er ythrocyte sedimentation rate, C-reactive protein, brood leukocyte and platelet count, and serum immunoglobulins G and A) and to nutritional status (concentrations of serum albumin, prealbumin, hemoglobin) impro ved rapidly and significantly with as little as 2 weeks' treatment in both treatment groups. In both groups, there was one relapse within 8 weeks after discontinuation of treatment, and one patient in both grou ps was operated on during the treatment period. During the routine fol low-up after the trial (0.3-2.5 years; mean, 1.3 years) five of the co rticosteroid group experienced a clinical relapse, whereas only one fr om the enteral feeding group relapsed. No side effects of enteral feed ing were seen. Enteral feeding with a whole protein-based formula prov ed to be as effective as high-dose corticosteroid in the treatment of the acute phase of Crohn's disease and may prove to be the treatment o f choice in pediatric patients with acute Crohn's disease.