| REVIEW ARTICLE |
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| Year : 2017 | Volume
: 2
| Issue : 4 | Page : 20-24 |
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Review of food-related symptoms in children with Crohn's disease following treatment with liquid enteral feeds
Babu Vadamalayan1, Mamoun Elawad2
1 King's College hospital, London, UK
2 Great Ormond Street Hospital, London, UK
Correspondence Address:
Babu Vadamalayan
King's College hospital, London
UK
 Source of Support: None, Conflict of Interest: None
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Aims: Whilst it is well established that liquid enteral feeds can effectively bring Crohn's disease into remission, it is still not clear as to the role that foods play in inducing symptoms. We aimed to review food related symptoms in children once disease was in remission following treatment with liquid enteral feed (the first line treatment for children presenting to our unit with Crohn's) with or without immunosuppressive treatment.
Methods: Children with Crohn's disease, presented between 2000-2005 and treated with liquid enteral feeds were reviewed. Paediatric Crohn's disease activity index (PCDAI), site of disease, and indicators of an allergic predisposition (atopy, non-food allergies) and results of blood tests for IgE and specific IgE to foods were recorded. Children were treated with liquid enteral feeds (E028 extra or Modulen) for 6-8 weeks then foods were individually introduced at 3-day intervals and foods that induced symptoms were avoided and reintroduced at later date.
Results: 16 of the 49 children had food related symptoms. Abdominal pain was the most common problem (12 cases). 10 of the 49 were atopic and all 10 had food related symptoms. 13/49 had raised total IgE and 3 of 21 positive specific IgE. Foods most commonly causing symptoms were milk products, wheat, egg, Soya, potatoes. PCDAI ranged from 0-18 (mean 5.8). 24 male (49%), 25 female (51%), aged 5-16 years (mean 15) were included in this study.
Conclusion: Food-associated symptoms occur in Crohn's children when re-starting a normal diet after a period of treatment with liquid enteral feeds. Atopic children are highly likely to develop food related symptoms and affected all atopic children in this study. Foods most commonly causing symptoms were milk, wheat, egg, Soya and potatoes. Individual reintroduction of food with dietician support is helpful if food-associated symptoms are to be detected.
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