Crohn's Disease Flashcards
Clinical features
Diarrhoea Abdo pain Anorexia Fever Intestinal obstruction
Complications
Fistulae Obstruction Strictures Ulcers Haemorrhage
40% occur
In ileocecal region
Surgical management
Take out diseased part but disease is not gone
Less GI tract for nutrient absorption
Surgical management:
Strictureplasty
Opens up narrowings of the bowel
Surgical management:
Resection
Part of small bowel removed
Proctocolectomy
Dietary management:
Child energy req
500-1400kcal higher than normal
Dietary management:
In those with strictures + obstructive symptoms
Diet with adapted texture or distal enteral nutrition
Benefits of nutrition support
Bowel rest
Social effects
Immunological effects
Intestinal adaptation
Exclusive enteral nutrition
Associated with 60-80% remission rate
Can decrease local + systemic inflammation
Promote weight gain
Exclusive enteral nutrition:
Modulen IBD
Nestle Contains TGF-B2 Whole protein powder Can be conc to 1.5kcal/ml Oral or tube feeding Can be flavoured
Exclusive enteral nutrition:
Supplementary
Overnight feeding
Oral supplements
Significant short-term benefits
Exclusive enteral nutrition:
Common feed related problems
Hunger Nausea Unable to manage feed volumes Diarrhoea School/social disruption
Exclusive enteral nutrition:
Forbes ESPEN guidelines
First line to induce remission in children + adolescents with active CD
Enteral nutrition as primary therapy
Cochrane review
Less effective than conventional corticosteroid therapy
