If you could treat your child’s Crohn’s disease with nutrition therapy instead of medication, would you do it? What if the nutrition therapy mostly involved drinking nutritional shakes instead of eating foods? Well, nutrition therapy is an effective treatment for Crohn’s Disease in children, and it’s known as enteral therapy. Here’s what you need to know about it.
What is Enteral Therapy, and How Does it Work?
Enteral therapy provides nutrition as a liquid formula rather than eating regular foods. This approach has been studied the most, and it requires not eating any food during treatment. Instead of eating, all of a child’s nutrition is met with a special drink or formula. Research has shown that these formulas are effective when taken as the sole source of nutrition. Recently, however, a study published by Children’s Hospital of Philadelphia showed that enteral therapy may still be effective when a small amount of food is taken at the same time as a supplement.
Enteral therapy is just as effective as steroids in children, and unlike steroids, there are virtually no side effects. This form of Crohn’s treatment has many benefits, including improved growth and mucosal healing. The way enteral therapy works is unclear, but it may improve good bacteria in the gut, improve overall nutrition or eliminate an unknown dietary substance that causes an immune response. Special prescription formulas are available, but research shows that over-the-counter options (in which the protein isn’t broken down as much) appear to be equally effective — good news, since non-prescription formulas are cheaper and taste better. Although enteral therapy is most commonly used in Europe and Japan, it is also considered a standard treatment option for Crohn’s disease in the United States.
Could Enteral Therapy be a Good Option for You?
Nationwide Children’s Hospital has developed a program to help patients and families overcome the barriers to successful enteral therapy, which may include the cost of formula, potential need for a feeding tube and difficulty dealing with eating little or no food during treatment. Over the past year, Nationwide Children’s has increased the number of patients who choose enteral therapy to treat Crohn’s disease. We have also been sharing many of the tools that we have developed with other treatment centers around the country to increase enteral therapy use in the United States.
Nationwide Children’s Hospital has also enlisted patients who have had success with enteral therapy to be available to offer support and guidance for other patients who are just getting started or in the process of doing enteral therapy. For example, Micah Cohen, now 15, was diagnosed with Crohn’s disease at age 11. After a couple of months of unsuccessfully trying to manage a flare by increasing levels of his medication, Micah was given a choice: try to manage the flare with a biologic medication infused into his blood, or try a nutrition program. After being told about the risks and benefits of each, Micah and his family made the decision to manage the flare with the enteral nutrition program, with immediate support and guidance from our nutrition team.
Micah was very hesitant, at first, because the nutritional treatment was very new for him, and he was worried how it would affect his day-to-day life. After seeing signs of remission after just one week of therapy, though, he was on board. “For the first time, I felt like I had some control over my Crohn’s without the side effects I noticed with my meds. I also didn’t have to wait so long between making a change and seeing results,” Micah explained. “My family and I went on vacation a week after beginning the therapy, and I was able to join in with biking and swimming and felt good.”
If you are interested in learning more about enteral therapy for Crohn’s disease or in working with one of our Crohn’s specialists, please visit our site.
Jen Smith, MS, RD, CSP, LD, LMT is a clinical dietitian at Nationwide Children’s Hospital. She has been working at Nationwide Children’s with an emphasis in Gastroenterology since 2003. She is a board certified specialist in pediatric nutrition.
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