Meta-analysis: enteral nutrition in active Crohn's disease in children

Aliment Pharmacol Ther. 2007 Sep 15;26(6):795-806. doi: 10.1111/j.1365-2036.2007.03431.x.


Background: Controversy exists surrounding the optimal treatment for inducing remission in active Crohn's disease.

Aim: To review and update evidence on the effectiveness of enteral nutrition (EN) in treating active Crohn's disease in children.

Methods: MEDLINE, EMBASE and The Cochrane Library (up to February 2007) were searched for randomized controlled trials (RCTs) relevant to Crohn's disease and EN in children.

Results: We included 11 RCTs (n = 394). Seven RCTs (n = 204) compared EN with corticosteroid therapy. On the basis of pooled results of four RCTs (n = 144), we found no significant difference in the remission rates between groups (relative risk, RR 0.97, 95% CI 0.7-1.4, random effect model). Four RCTs (n = 190) compared two EN regimens. One of the four RCTs (n = 50) revealed a significant increase in the percentage of patients achieving remission in the total EN group compared with the partial EN group (RR 2.7, 95% CI 1-7.4). Because of lack of data, formal pooling of results was not possible for many outcomes (e.g., time until remission, duration of remission, growth data).

Conclusions: Limited data suggest similar efficacy for EN and corticosteroids. As the number of patients needed to provide a definite answer is too large, future studies should focus on detailed outcome measurements including growth and quality of life.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use
  • Child
  • Crohn Disease / therapy*
  • Enteral Nutrition*
  • Female
  • Gastrointestinal Agents / pharmacology
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Male
  • Quality of Life / psychology
  • Remission Induction / methods
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Gastrointestinal Agents