Is the frequency of dietitian support associated with greater clinical improvements in adults with Crohn's disease undertaking exclusive enteral nutrition?

No Thumbnail Available
File version
Author(s)
Purcell, Liz
Mutsekwa, Rumbidzai
Angus, Rebecca
Shukla, Dheeraj
Palmer, Michelle
Primary Supervisor
Other Supervisors
Editor(s)
Date
2022
Size
File type(s)
Location
License
Abstract

Background: Exclusive enteral nutrition (EEN) is considered to be an effective, low-risk therapy in the treatment of Crohn's disease (CD). Frequent dietetic support may assist adults to succeed. The present observational study aimed to compare whether the frequency of dietetic support during EEN therapy was associated with differences in clinical and nutritional outcomes across two gastroenterology inflammatory bowel disease services. Site A provided ≥3 visits plus more if clinically indicated and Site B provided weekly support. Methods: Eligible patients were adults with active CD recommended to be treated with oral EEN for ≥6 weeks between February 2018 and December 2019. Demographic, anthropometric, clinical, medications, pathology and EEN treatment descriptors were sourced from the medical chart. Descriptive statistics, as well as chi-squared and t tests, were used to compare data between sites. Results: Eighty-four CD patients were eligible (44 ± 14 years, 54% female, baseline Crohn's disease activity index [CDAI] 259.5 ± 113.1, n = 51 Site A) and completed EEN for median (range) 6.1 (1–12) weeks. Most patients (82%, n = 69/84) completed ≥6 weeks of EEN treatment. CDAI score and calprotectin improved across the total sample from pre- to post-EEN by −109.8 ± 92.1 (p < 0.001) and −65 µg g–1 (−65,230 to 4370) (p = 0.002), respectively. Dietitian occasions of service were more frequent at Site B (7 [4–12] occasions vs. 3 [1–8], p < 0.001). However, changes in clinical and biomarker data were similar between sites (p < 0.05). Conclusions: EEN with regular dietetic input resulted in clinical and biochemical improvements for patients with active CD. Tailoring dietetic support based on the client's needs and preference may achieve clinical improvements similar to providing weekly dietetic support to adults on EEN.

Journal Title

Journal of Human Nutrition and Dietetics

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note

This publication has been entered in Griffith Research Online as an advanced online version.

Access the data
Related item(s)
Subject

Biochemistry and cell biology

Nutrition and dietetics

Science & Technology

Life Sciences & Biomedicine

Nutrition & Dietetics

clinical nutrition

clinical practice

Crohn's disease

dietary intervention

dietetics

gastroenterology

Persistent link to this record
Citation

Purcell, L; Mutsekwa, R; Angus, R; Shukla, D; Palmer, M, Is the frequency of dietitian support associated with greater clinical improvements in adults with Crohn's disease undertaking exclusive enteral nutrition?, Journal of Human Nutrition and Dietetics, 2022

Collections