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Objective: To compare the effectiveness of corticosteroids (CS) versus exclusive enteral nutrition (EEN), as induction therapy of Crohn’s disease to induce remission. Design: Systematic literature review. Methods: Searches were done in PubMed utilizing the terms: enteral nutrition therapy, exclusive enteral nutrition, inflammatory bowel disease, Crohn’s disease, corticosteroids, pediatric, nutrition, and steroids. Articles were excluded with patients > 18 years of age, confounding variables, inclusion of other treatment options, or physician discretion bias in selecting a treatment option. Results: Ultimately, three articles were included in our review. Two of three studies examined showed a statistically significant improvement in remission rates in patients receiving EEN with one study showing similar rates. Patients receiving EEN were also noted to have improved intestinal healing, improved growth, and decreased need for biologic agents compared to patients receiving CS treatment. Conclusion: EEN appears to be an effective and possibly more beneficial treatment option as it is associated with fewer adverse reactions, promotes intestinal healing, and has similar remission and relapse rates as CS. It cannot be confirmed that EEN will be the preferred induction therapy as the treatment choice must be individualized. Further studies must be done to expand knowledge on the topic. Cost effectiveness and patient compliance are drawbacks to EEN therapy.
Hutchison SH, Stottlar RL.Exclusive Enteral Nutrition and Corticosteroids: Two Effective Methods of Induction Treatment in Crohn’s Disease. JMU Scholarly Commons Physician Assistant Capstones. https://commons.lib.jmu.edu/pacapstones/. Published December 11, 2019.