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Exclusive enteral nutrition

Katherine A Dunn, Jessica Moore-Connors, Brad MacIntyre, Andrew Stadnyk, Nikhil A Thomas, Angela Noble, Gamal Mahdi, Mohsin Rashid, Anthony R Otley, Joseph P Bielawski, Johan Van Limbergen
BACKGROUND: Exclusive enteral nutrition (EEN) is a first-line therapy in pediatric Crohn's disease (CD) thought to induce remission through changes in the gut microbiome. With microbiome assessment largely focused on microbial taxonomy and diversity, it remains unclear to what extent EEN induces functional changes that thereby contribute to its therapeutic effect. METHODS: Fecal samples were collected from 15 pediatric CD patients prior to and after EEN treatment, as well as from 5 healthy controls...
November 2016: Inflammatory Bowel Diseases
Ronaldo Sousa Oliveira Filho, Lia Mara Kauchi Ribeiro, Lucia Caruso, Patricia Azevedo Lima, Náglia Raquel Teixeira Damasceno, Francisco García Soriano
INTRODUCTION: Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. OBJECTIVE: To apply and monitor QINT for critically ill patients at nutritional risk. METHODS: Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored...
September 20, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Jacomine E Hogewind-Schoonenboom, Lyanne W W Rövekamp-Abels, Daphne P M de Wijs-Meijler, Margaux D Maduro, Marijke C Jansen-van der Weide, Johannes B van Goudoever, Jessie M Hulst
OBJECTIVE: Early growth rates and feeding advancement rates of preterm infants are thought to influence later health. Feeding advancement is often difficult due to feeding intolerance. Exclusive human milk feeding improves tolerance, but can result in a lower weight gain rate. The addition of human milk fortifier has advantages for growth, but there are concerns that it may nullify the beneficial effect of human milk on tolerance. Therefore, the objective of this study was to evaluate the relationship between the amount of fortified human milk or formula and feeding tolerance and growth in preterm infants...
October 5, 2016: Journal of Pediatric Gastroenterology and Nutrition
Yu Qi Qiao, Chen Wen Cai, Zhi Hua Ran
Inflammatory bowel disease (IBD) patients exhibit impaired control of the microbiome in the gut. "Dysbiosis" is commonly observed. A Western diet is a risk factor for the development of IBD but may have different effects on the gut microbiota in IBD and non-IBD individuals. Exclusive enteral nutrition (EEN) can induce remission in pediatric Crohn's disease (CD) with a decrease in gut microbiome diversity after EEN treatment. Although there are some theoretical benefits, the actual treatment effects of prebiotics and probiotics in IBD patients can vary...
October 15, 2016: Journal of Digestive Diseases
Sumeet Reddy, Michael Bailey, Richard Beasley, Rinaldo Bellomo, Diane Mackle, Alex Psirides, Paul Young
OBJECTIVE: To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9% (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. DESIGN AND SETTING: A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. PARTICIPANTS: All adult patients who required crystalloid fluid therapy as part of the 0...
September 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Anndrea Flint, Karen New, Mark W Davies
BACKGROUND: Breast milk provides optimal nutrition for term and preterm infants, and the ideal way for infants to receive breast milk is through suckling at the breast. Unfortunately, this may not always be possible for medical or physiological reasons such as being born sick or preterm and as a result requiring supplemental feeding. Currently, there are various ways in which infants can receive supplemental feeds. Traditionally in neonatal and maternity units, bottles and nasogastric tubes have been used; however, cup feeding is becoming increasingly popular as a means of offering supplemental feeds in an attempt to improve breastfeeding rates...
2016: Cochrane Database of Systematic Reviews
Zhen Guo, Jianfeng Gong, Yi Li, Lili Gu, Lei Cao, Zhiming Wang, Weiming Zhu, Jieshou Li
MicroRNAs (miRNAs) have been shown to be important for the pathogenesis of Crohn's disease (CD). Exclusive enteral nutrition (EEN) is an effective therapy for inducing remission in CD. We aimed to investigate the alteration of miRNAs expression profile in the terminal ileal mucosa of CD patients before and after EEN. Twenty-five patients and ten healthy individuals were included. MiRNAs expression profile was firstly assessed using microarray technology and then validation was performed by qRT-PCR. The correlations between miRNAs and CD activity index (CDAI) score and serum C-reactive protein (CRP) level were also evaluated...
August 22, 2016: Nutrients
Deborah Dumphy, Julie Thompson, Myra Clark
BACKGROUND: Breastfeeding is the gold standard nutrition for infants, and more than three-fourths of US mother-infant couplets initiate breastfeeding at birth. However, breastfeeding rates plummet after hospital discharge, when mother-infant couplets enter primary care. This quality improvement project examined the effect of a primary care intervention on breastfeeding rates from the newborn visit through the 4-month visit. OBJECTIVE: The overall aim of this evidence-based quality improvement project was to increase breastfeeding rates by refining the care provided to a diverse patient population with historically low breastfeeding rates...
August 8, 2016: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Gijs H K Berkelmans, Bas J W Wilts, Ewout A Kouwenhoven, Koshi Kumagai, Magnus Nilsson, Teus J Weijs, Grard A P Nieuwenhuijzen, Marc J van Det, Misha D P Luyer
INTRODUCTION: Early start of an oral diet is safe and beneficial in most types of gastrointestinal surgery and is a crucial part of fast track or enhanced recovery protocols. However, the feasibility and safety of oral intake directly following oesophagectomy remain unclear. The aim of this study is to investigate the effects of early versus delayed start of oral intake on postoperative recovery following oesophagectomy. METHODS AND ANALYSIS: This is an open-label multicentre randomised controlled trial...
August 5, 2016: BMJ Open
Mohamed Mutalib, Khaled Bezanti, Mamoun Elawad, Fevronia Kiparissi
BACKGROUND: Orofacial granulomatosis (OFG) is a term used to describe a persistent, painless swelling of lips and orofacial region. It can be associated with ulceration, gingival hypertrophy and cobble stone appearance of the buccal mucosa. OFG is commonly associated with Crohn's disease and can precede the intestinal manifestation of the disease. Exclusive enteral nutrition (EEN) is a recognized treatment for induction of remission for Crohn's disease. The aim of this study was to review the use of EEN in the management of OFG in children...
July 23, 2016: World Journal of Pediatrics: WJP
Alexander Reinisch, Juliane Liese, Guido Woeste, Wolf Bechstein, Nils Habbe
Enteroatmospheric fistulas (EAFs) represent a challenging problem in patients with an open abdomen (OA). A retrospective, descriptive study was conducted to evaluate the effects of enteral alimentation on wound status and management and nutrition. All patients with an EAF in an OA treated between October 2012 and December 2014 at a university hospital in Germany were included without criteria for exclusions. Demographic and morbidity-related data collected included age, gender, surgeries, OA grading, body mass index (BMI), serum albumin, and serum creatinin...
July 2016: Ostomy/wound Management
Hyun Jin Kim, Young Kim, Jin Min Cho, Seak Hee Oh, Kyung Mo Kim
PURPOSE: Exclusive enteral nutrition (EEN) therapy effectively induces clinical remission in Crohn's disease (CD). It remains unclear, however, whether partial enteral nutrition (PEN) can maintain remission. This study was performed to determine the abilities of oral EEN and oral PEN to induce and maintain clinical remission in pediatric patients with CD, respectively. MATERIALS AND METHODS: Pediatric patients with CD who received oral EEN at a single center in 2000-2014 were identified retrospectively...
September 2016: Yonsei Medical Journal
Lillemor Berntson, Iris Hedlund-Treutiger, Kjell Alving
OBJECTIVES: There is extensive evidence for an influence of gut microbiota on the immune system, which has consequences for inflammatory diseases. Exclusive enteral nutrition (EEN), which may change the gut microbiota, is an effective anti-inflammatory treatment for Crohn's disease in children. We wanted to explore the immediate anti-inflammatory effect of EEN in children with juvenile idiopathic arthritis (JIA). METHODS: Thirteen patients with JIA (7-17 years of age), in a disease flare-up, were included in the study...
July 4, 2016: Clinical and Experimental Rheumatology
Nicole T Spillane, Sudha Kashyap, David Bateman, Marilyn Weindler, Ganga Krishnamurthy
INTRODUCTION: Infants with hypoplastic left heart syndrome are at risk for growth failure, particularly after stage 1 procedures. The effect of continuous enteral feedings on weight gain has not been previously investigated. METHODS: A randomized controlled trial was performed in infants with hypoplastic left heart syndrome and single ventricle variants after stage 1 procedures. Eligible infants were randomized to a continuous and intermittent feeding regimen or an exclusive intermittent feeding regimen after stage 1 procedures and continued until hospital discharge...
July 2016: World Journal for Pediatric & Congenital Heart Surgery
Nadeem O Kaakoush, Andrew S Day, Steven T Leach, Daniel A Lemberg, Hazel M Mitchell
No abstract text is available yet for this article.
July 2016: American Journal of Gastroenterology
Frank M Ruemmele
The incidence of inflammatory bowel disease (IBD) is steadily in the rise in Western as well as in developing countries paralleling the increase of westernized diets, characterized by high protein and fat as well as excessive sugar intake, with less vegetables and fiber. An interesting hypothesis is that environmental (food-) triggered changes of the intestinal microbiome might cause a proinflammatory state preceding the development of IBD. Indeed, an intact intestinal epithelial barrier assuring a normal bacterial clearance of the intestinal surface is crucial to guarantee intestinal homeostasis...
2016: Annals of Nutrition & Metabolism
A E Wiskin, R Haggarty, N A Afzal, A Batra, S A Wootton, R M Beattie
BACKGROUND/OBJECTIVES: Children with Crohn's disease often demonstrate nutritional recovery during primary therapy at diagnosis, but long-term nutritional support is sometimes necessary. Evidence to inform best nutritional practice including energy and micronutrient requirements is limited. The principal objective of this study was to determine how energy expenditure and physical activity vary with disease activity over the first year following diagnosis. SUBJECTS/METHODS: Twenty children were studied at diagnosis with Crohn's disease and were followed up over 1 year while receiving treatment according to national guidelines...
June 22, 2016: European Journal of Clinical Nutrition
Francesca Penagini, Dario Dilillo, Barbara Borsani, Lucia Cococcioni, Erica Galli, Giorgio Bedogni, Giovanna Zuin, Gian Vincenzo Zuccotti
Nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of disease. With regards to etiology, there are pediatric data, mainly from case-control studies, which suggest that some dietary habits (for example consumption of animal protein, fatty foods, high sugar intake) may predispose patients to IBD onset. As for disease treatment, exclusive enteral nutrition (EEN) is an extensively studied, well established, and valid approach to the remission of pediatric Crohn's disease (CD)...
2016: Nutrients
Ana Muñoz Lozón, Cristina Iglesias Blázquez, Cristina Menéndez Arias, Patricia Domínguez Sánchez
A 10 year old girl with diarrhea, abdominal pain, weight loss and fever of one month and a half of evolution. Analytical and sonographic findings raised the possibility of inflammatory bowel disease. Endoscopy and histology showed findings consistent with Crohn's disease. Treatment was initiated with mesalazine and exclusive enteral nutrition. Later corticosteroid treatment, immunosuppressive drugs and ursodeoxycholic acid were added due to cholestasis and persistent hypergammaglobulinemia. Magnetic resonance cholangiography and liver biopsy confirmed the diagnosis of concomitant primary sclerosing cholangitis...
June 1, 2016: Archivos Argentinos de Pediatría
Lisa Bounoure, Filomena Gomes, Zeno Stanga, Ulrich Keller, Rémy Meier, Peter Ballmer, Rebecca Fehr, Beat Mueller, Laurence Genton, Pauline Coti Bertrand, Kristina Norman, Christoph Henzen, Alessandro Laviano, Stephan Bischoff, Stéphane M Schneider, Jens Kondrup, Philipp Schuetz
OBJECTIVE: Despite the high prevalence of malnutrition in the general inpatient population, there is a lack of knowledge in regard to detecting disease-related malnutrition and implementing nutritional support. Our aim was to suggest practical procedures for screening and treating malnourished or at-risk patients hospitalized in medical wards, thereby fostering a straightforward implementation of nutritional therapy independent of the underlying disease and comorbidities. METHODS: A working group of experts in clinical nutrition selected and analyzed published disease-specific European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines relevant for our aim...
July 2016: Nutrition
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