IBD Resources and Tools
Downloadable resources
Clinical Summary Booklet
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Patient Information Leaflet
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Modulen Food Reintroduction Guidelines (Side A)
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Modulen Food Reintroduction Guidelines (Side B)
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Recent Crohn’s Abstracts
We would recommend you read the following papers.
Systematic review: nutritional therapy in paediatric Crohn's disease
82: Aliment Pharmacol Ther. 2008 Feb 15; 27 (4): 293-307. Epub 2007 Nov 27.
Day AS, Whitten KE, Sidler M, Lemberg DA.
Department of Gastroenterology, Sydney Children's Hospital, Sydney, Australia.
BACKGROUND: At least 25% of individuals diagnosed with Crohn's disease (CD) have
onset of disease in childhood. Almost all children with CD have nutritional
impairments, such as weight loss or stunting, at diagnosis or subsequently.
Nutritional therapy (exclusive enteral nutrition) is established as a valid and
effective treatment in paediatric CD. The advantages of this approach are
induction of remission and control of inflammatory changes, mucosal healing, positive benefits to growth and overall nutritional status, and avoidance of other medical therapies.
AIM: To provide a comprehensive up-to-date review of the roles of nutritional therapy in CD and of the data supporting this therapy.
METHODS: A search of PubMed was performed with search terms 'enteral nutrition',
'nutritional therapy', 'Crohn disease' and 'children'. Relevant articles were
selected from this search. In addition, the reference lists of available articles
were reviewed for further relevant articles.
RESULTS: Nutritional therapy offers numerous benefits in the management of CD. Recent work has begun to elucidate the likely mechanisms of this therapy. These include direct mucosal anti-inflammatory effects and alteration of intestinal microflora.
CONCLUSION: Further studies are required to define longer-term effects of nutritional therapy in patients with CD.
Review article: the evidence base for interventions used to maintain remission in
Crohn's disease
129: Aliment Pharmacol Ther. 2008 Jan 1; 27(1): 11-8. Epub 2007 Oct 5. Akobeng AK.
Department of Paediatric Gastroenterology, Booth Hall Children's Hospital,
Central Manchester and Manchester Children's University Hospitals, Manchester, UK.
BACKGROUND: Crohn's disease is characterised by recurrent flare-ups alternating
with periods of remission. A number of interventions are currently used in
clinical practice to try and maintain remission in Crohn's disease but the
evidence base for some of them may be questionable. AIM: To review the available
evidence on interventions, which are currently used to maintain remission in
Crohn's disease.
METHODS: The Cochrane Library and Medline (Pubmed) were searched
for level 1 evidence on specific interventions. Search terms included 'Crohn's
disease or synonyms', 'remission or synonyms' and the names of specific
interventions.
RESULTS: Azathioprine, infliximab and adalimumab are effective at
maintaining remission in Crohn's disease. Natalizumab is also effective, but
there are concerns about its potential association with progressive multifocal
leukoencephalopathy. Long-term enteral nutritional supplementation,
enteric-coated omega-3 fatty acids and intramuscular methotrexate may also be
effective but the evidence for these is based on relatively small studies. The
available evidence does not support the use of oral 5-aminosalicylates agents,
corticosteroids, anti-mycobacterial agents, probiotics or ciclosporin as
maintenance therapy in Crohn's disease.
CONCLUSION: A better understanding of the
evidence base of existing interventions could result in the use of treatments,
which are more likely to lead to improved patient outcomes.
If you would like to more information about IBD, the following organisations may be of interest:
• www.nacc.org.uk
• www.bda.uk.com
• www.cicra.org
• www.bsg.org.uk
• www.bspghan.org.uk