Current Nutritional Therapy Approaches in Pediatric İnflammatory Diseases
PDF
Cite
Share
Request
Review
P: 103-115
April 2022

Current Nutritional Therapy Approaches in Pediatric İnflammatory Diseases

J Curr Pediatr 2022;20(1):103-115
1. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye
No information available.
No information available
Received Date: 09.08.2021
Accepted Date: 26.12.2021
Publish Date: 22.04.2022
PDF
Cite
Share
Request

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic, recurrent immune disorder of unknown etiology that affects millions of people globally. The etiopathogenesis of IBD is complex and involves the interaction of genetic, environmental, and microbial factors and immunological responses. Although there is no known definitive treatment for IBD, the main goal is to provide a medical and surgical treatment and nutritional intervention that reverses the mucosal inflammatory response, maintains disease remission, prevents malignancy, optimizes nutrition, and improves quality of life. Diet and nutritional factors are important environmental factors that play a role in the etiology of IBD. It is known that the Western diet, characterized by high amounts of fat and refined sugar, and low amounts of fiber and vegetables, exacerbates chronic inflammation in the gut and is associated with increased levels of proinflammatory cytokines, impaired intestinal permeability and intestinal microbiota changes. The main goals of nutritional therapy in pediatric IBD are to relieve symptoms, maintain remission, improve quality of life, ensure normal growth and development, and prevent complications. Multidisciplinary evaluation of children with IBD should be encouraged and nutritional recommendations should be developed individually. Medical nutrition therapy, which is considered as the only treatment option in some cases, is also of great importance in terms of preventing the progression of the disease, nutrient deficiencies, malnutrition or other long-term complications.

References

1Rufo PA, Bousvaros A. Current Therapy of Inflammatory Bowel Disease in Children. Pediatr Drugs 2006;8:279-302.
2Conrad MA, Rosh JR. Pediatric Inflammatory Bowel Disease. Pediatr Clin North Am 2017;64:577-91.
3Rosen MJ, Dhawan A, Saeed SA. Inflammatory Bowel Disease in Children and Adolescents. JAMA Pediatr 2015;169:1053-60.
4Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med 2009;361:2066-78.
5D’Arcangelo G, Aloi M. Treat-to-Target in Pediatric Inflammatory Bowel Disease: What Does the Evidence Say? Paediatr Drugs 2020;22:463-72.
6Baldwin KR, Kaplan JL. Medical management of pediatric inflammatory bowel disease. Semin Pediatr Surg 2017;26:360-6.
7Amaro F, Chiarelli F. Growth and Puberty in Children with Inflammatory Bowel Diseases. Biomedicines 2020;8.
8Park S, Kang Y, Koh H, Kim S. Increasing incidence of inflammatory bowel disease in children and adolescents: significance of environmental factors. Clin Exp Pediatr 2020;63:337-44.
9Sairenji T, Collins KL, Evans DV. An Update on Inflammatory Bowel Disease. Prim Care 2017;44:673-92.4.
10Benchimol EI, Mack DR, Nguyen GC, Snapper SB, Li W, Mojaverian N, et al. Incidence, outcomes, and health services burden of very early onset inflammatory bowel disease. Gastroenterology 2014;147:803-13.e7; quiz e14-5.
11Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet (London, England) 2018;390:2769-78.
12Buran T. İnflamatuar Barsak Hastalığında Epidemiyoloji, Prevalans ve İnsidansı. Turkiye Klinikleri J Gastroenterohepatol-Special Topics 2017;10.
13Oliveira SB, Monteiro IM. Diagnosis and management of inflammatory bowel disease in children. BMJ (Clinical Res) 2017;357:j2083-j.
14Däbritz J, Gerner P, Enninger A, Claßen M, Radke M. Inflammatory Bowel Disease in Childhood and Adolescence. Dtsch Arztebl Int 2017;114:331-8.
15Sood A, Ahuja V, Kedia S, Midha V, Mahajan R, Mehta V, et al. Diet and inflammatory bowel disease: The Asian Working Group Guidelines. Indian J Gastroenterol 2019;38;220-46.
16Kim JY. Dietary role in the development and treatment of inflammatory bowel disease. Clin Exp Pediatr 2020;63:355-6.
17Ruemmele FM, Veres G, Kolho KL, Griffiths A, Levine A, Escher JC, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014;8:1179-207.
18Turner D, Ruemmele FM, Orlanski-Meyer E, Griffiths AM, de Carpi JM, Bronsky J, et al. Management of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care-An Evidence-based Guideline From European Crohn’s and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018;67:257-91.
19Hancock L, Windsor AC, Mortensen NJ. Inflammatory bowel disease: the view of the surgeon. Colorectal Dis 2006;1(Suppl8):10-4.
20Bischoff SC, Escher J, Hébuterne X, Kłęk S, Krznaric Z, Schneider S, et al. ESPEN practical guideline: Clinical Nutrition in inflammatory bowel disease. Clin Nutr 2020;39:632-53.
21Miele E, Shamir R, Aloi M, Assa A, Braegger C, Bronsky J, et al. Nutrition in Pediatric Inflammatory Bowel Disease: A Position Paper on Behalf of the Porto Inflammatory Bowel Disease Group of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018;66.
22Balestrieri P, Ribolsi M, Guarino MPL, Emerenziani S, Altomare A, Cicala M. Nutritional Aspects in Inflammatory Bowel Diseases. Nutrients 2020;12.
23Yu Y, Chen KC, Chen J. Exclusive enteral nutrition versus corticosteroids for treatment of pediatric Crohn’s disease: a meta-analysis. World J Pediatr 2019;15:26-36.
24 Narula N, Dhillon A, Zhang D, Sherlock ME, Tondeur M, Zachos M. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2018;4(4):Cd000542.
25Souza GN, Draghi PF, Yonamine GH. Oral and Enteral Nutrition Therapy in Inflammatory Bowel Diseases Among the Pediatric Population: A Literature Review. Rev Paul Pediatr 2020;38:e2019032.
26Scarallo L, Lionetti P. Dietary Management in Pediatric Patients with Crohn’s Disease. Nutrients 2021;13:1611.
27Herrador-López M, Martín-Masot R, Navas-López VM. EEN Yesterday and Today … CDED Today and Tomorrow. Nutrients 2020;12.
28Sevinç, E. İnflamatuvar barsak hastalığı olan çocuk hastalarımızın değerlendirilmesi. Endoskopi Gastrointestinal 2017;25:35-9.
29Lane ER, Lee D, Suskind DL. Dietary Therapies in Pediatric Inflammatory Bowel Disease: An Evolving Inflammatory Bowel Disease Paradigm. Gastroenterol Clin North Am 2017;46:731-44.
30Cohen-Dolev N, Sladek M, Hussey S, Turner D, Veres G, Koletzko S, et al. Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn’s Disease: Results From the GROWTH CD Study. J Crohns Colitis 2018;12:306-12.
31van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Fagerberg UL, et al. The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update. J Crohns Colitis; 2020.
32Cucinotta U, Romano C, Dipasquale V. Diet and Nutrition in Pediatric Inflammatory Bowel Diseases. Nutrients 2021;13.
33Lee D, Baldassano RN, Otley AR, Albenberg L, Griffiths AM, Compher C, et al. Comparative Effectiveness of Nutritional and Biological Therapy in North American Children with Active Crohn’s Disease. Inflamm Bowel Dis 2015;21:1786-93.
34Durchschein F, Petritsch W, Hammer HF. Diet therapy for inflammatory bowel diseases: The established and the new. World J Gastroenterol 2016;22:2179-94.
35Miele E, Pascarella F, Giannetti E, Quaglietta L, Baldassano RN, Staiano A. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104:437-43.
36Bousvaros A, Guandalini S, Baldassano RN, Botelho C, Evans J, Ferry GD, et al. A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohn’s disease. Inflamm Bowel Dis 2005;11:833-9.
37Shen J, Ran HZ, Yin MH, Zhou TX, Xiao DS. Meta-analysis: the effect and adverse events of Lactobacilli versus placebo in maintenance therapy for Crohn disease. Intern Med J 2009;39:103-9.
38Cohen SA, Gold BD, Oliva S, Lewis J, Stallworth A, Koch B, et al. Clinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn disease. J Pediatr Gastroenterol Nutr 2014;59:516-21.
39Suskind DL, Lee D, Kim YM, Wahbeh G, Singh N, Braly K, et al. The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial. Nutrients 2020;12.
40Sigall-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;20:1353-60.
41Levine A, Wine E, Assa A, Sigall Boneh R, Shaoul R, Kori M, et al. Crohn’s Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial. Gastroenterology 2019;157:440-50.e8.
42Svolos V, Hansen R, Nichols B, Quince C, Ijaz UZ, Papadopoulou RT, et al. Treatment of Active Crohn’s Disease With an Ordinary Food-based Diet That Replicates Exclusive Enteral Nutrition. Gastroenterology 2019;156:1354-67.e6.
43Sasson AN, Ananthakrishnan AN, Raman M. Diet in Treatment of Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol 2021;19:425-35.e3.
44Bekiç C, Ünsal B. Ulcerative colitis and diet. TJG 2012;23(Suppl 2):3-6.
45Ley D, Duhamel A, Behal H, Vasseur F, Sarter H, Michaud L, et al. Growth Pattern in Paediatric Crohn Disease Is Related to Inflammatory Status. J Pediatr Gastroenterol Nutr 2016;63:637-43.
46Pekmez CT, Samur G, Aydemir Y, Özen H, Yüce A. İnflamatuvar Barsak Hastalığı Olan Çocuklarda Malnütrisyon ve Beslenme Durumunun Değerlendirilmesi. Bes Diy Der 2015;43.
47Nasiri S, Kuenzig ME, Benchimol EI. Long-term outcomes of pediatric inflammatory bowel disease. Semin Pediatr Surg 2017;26:398-404.
48Di Chio T, Sokollik C, Peroni DG, Hart L, Simonetti G, Righini-Grunder F, et al. Nutritional Aspects of Pediatric Gastrointestinal Diseases. Nutrients 2021;13.
49Wędrychowicz A, Zając A, Tomasik P. Advances in nutritional therapy in inflammatory bowel diseases: Review. World J Gastroenterol 2016;22:1045-66.
50Green N, Miller T, Suskind D, Lee D. A Review of Dietary Therapy for IBD and a Vision for the Future. Nutrients 2019;11.
Article is only available in PDF format. Show PDF
2024 ©️ Galenos Publishing House