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Nutrition Therapy and Crohn's Disease

What Is Nutrition Therapy?

Nutrition therapy (or medical nutrition therapy) is way to treat health conditions (or their symptoms) with a special diet. The diet can be created by a doctor or registered dietitian.

What Is Nutrition Therapy for Crohn's Disease?

Crohn's disease is a type of inflammatory bowel disease (IBD) that causes inflammation of the intestines. Nutrition therapy uses a special formula and other diet restrictions to control inflammation and promote healing in Crohn's disease.

Why Is Nutrition Therapy Done for Crohn's Disease?

Nutrition therapy is an alternative to steroids and other medicines that doctors use to ease the symptoms of Crohn's disease. Steroids can have serious side effects, including poor growth and increased chance of infections.

Nutrition therapy can help improve nutrition and growth, decrease inflammation, and heal the gastrointestinal tract.

How Does Nutrition Therapy Work?

The two types of nutrition therapy used to manage Crohn's symptoms are:

  • exclusive enteral nutrition (EEN), also called total enteral nutrition (TEN): This is when the special formula is used for all meals (plain water and some other liquids may be allowed).
  • partial enteral nutrition (PEN): Some food is allowed in addition to the special formula. This makes the diet easier to follow. PEN is used to improve nutrition and prevent flare-ups (when symptoms get worse).

Some kids get nutrition therapy through a tube (a nasogastric, or NG, tube) that runs from the nose into the stomach.

Providing balanced nutrition with special formula gives the gut a chance to heal. Nutrition therapy may also work by changing the mix of bacteria that lives in the gut. Good bacteria in the gut can help protect the intestinal lining and regulate the immune system.

How Long Do People Need Nutrition Therapy?

How long someone gets nutrition therapy can vary, but it's usually for 3 to 12 weeks. Kids can start to get nutrition therapy right when they're diagnosed with Crohn's disease and during flare-ups.

What Happens After Nutrition Therapy?

After a few weeks of nutrition therapy, a normal diet is slowly reintroduced, with the amount of formula decreasing as more food is given.

When symptoms are under control, you'll make a plan with your child's doctor to help keep symptoms under control and prevent flare-ups. This may include a balance of regular food and PEN or starting maintenance medicines.

Are There Any Risks From Nutrition Therapy?

Nutrition therapy is very safe. But because the formula doesn't taste good, it can be hard for kids and teens to stick with the diet. Allowing some food in addition to formula may help to keep kids on the diet. The formula also might cause stomach upset, vomiting, and diarrhea.

Nutrition therapy helps improve overall nutrition for people with Crohn's disease. However, refeeding syndrome is a very rare and serious complication of enteral nutrition in severely malnourished children.

Children with Crohn's disease may become malnourished (not eating enough food or getting enough nutrients from food) because:

  • belly pain, nausea, and other problems decrease their appetite
  • the body needs more calories, especially during flare-ups
  • digestion is poor and nutrients aren't absorbed

Shifts in fluids and electrolytes happen after starting nutrition therapy in severely malnourished children. This increases the chance for irregular heartbeats, breathing problems, and seizures. So, these children are hospitalized and monitored when they get nutrition therapy.

Date reviewed: October 2017