Enteral nutrition therapy for people with Crohn’s disease who have active inflammation allows the intestines time to rest and heal. This treatment involves drinking a nutritionally complete formula that is easier for the body to digest. While the formula may be beneficial in reducing Crohn’s disease symptoms, a person may find it difficult to drink nothing but the formula for up to 12 weeks.
Crohn’s disease can cause debilitating symptoms, including stomach pain, gut ulcers, and diarrhea. These symptoms mean that a person may not absorb nutrients as they should. This can be especially concerning for children who need to grow.
The enteral diet can offer a solution to children or adults with Crohn’s disease who need to improve their nutrition absorption or are awaiting or recovering from surgery.
This article will explain the enteral diet, its potential benefits for people with Crohn’s disease, and other nutritional therapy options for Crohn’s disease management.
An enteral diet involves receiving micronutrients and macronutrients through specialized liquid formulas. “Enteral” means that the nutrition passes through the intestines.
As a drink
A person can have these formulas as a drink. Examples of enteral diet drinks include Boost, Ensure, and Orgain.
This drink can be in addition to their current diet or as a substitute for all food, since the drink contains all the proteins, carbohydrates, fats, minerals, and vitamins a person needs. Different formula types exist, including some that do not contain lactose or gluten.
A healthcare professional can help a person choose which formula type to use. Some feeding formulas also exist that contain special compounds to promote intestinal healing.
Through a tube
A person may also receive this nutrition through a feeding tube. This can either be a thin, flexible tube that doctors thread through the nose until it reaches the stomach, or a tube that doctors place surgically to provide entry to the stomach.
Types of feeding tubes include:
- Nasogastric tube (NG tube): Doctors thread this tube down through one of the nostrils until it reaches the stomach.
- Nasoduodenal tube (ND tube) or nasojejunal tube (NJ tube): Doctors thread this tube down through one of the nostrils until it reaches a specific place in the small intestine.
- Gastronomy tube (G-tube) or jejunostomy tube (J-tube): Doctors insert this tube directly into the stomach or intestine through a surgical incision they make in a person’s skin.
When enteral feedings involve a tube, doctors may connect it to a pump that delivers the formula at a set rate. They work much like an intravenous line, but instead of providing medicines to a vein, the enteral feeding pump gives the formula directly to the stomach.
A doctor may recommend an enteral diet to give a person’s digestive system a rest. When it receives enteral feedings, the system does not have to churn or digest food material. Instead, the formula can pass directly into a person’s intestines, where the intestines absorb key nutrients.
An enteral diet can also:
- increase remission rates
- heal the lining of the gastrointestinal tract
- improve overall nutrition
- cause weight gain
- increase muscle mass
- enhance bone health
Children with Crohn’s disease may not gain weight as easily as those without the condition. The intestinal inflammation the condition causes means that their bodies may not correctly absorb the nutrients needed to help them grow.
A doctor can also give an adult more information on the pros and cons of the enteral diet for their condition.
The following are some potential benefits of enteral nutrition therapy for people with Crohn’s disease.
Reduces gut inflammation
Because Crohn’s disease symptoms worsen with active inflammation, reducing inflammation through enteral feedings can help.
Enhances the gut microbiome
The microbiome is the balance of bacteria in the stomach and intestine. An imbalance of the microbiome in people with Crohn’s disease can potentially lead to inflammation and an overgrowth of “unhealthy” bacteria.
Enteral nutrition can help to
Enhances nutritional status
Sometimes, a doctor may recommend enteral nutrition as a supplemental therapy to enhance a person’s nutritional intake. This means having enteral nutrition in addition to eating a normal diet.
Improves nutrition before and after surgery
People with Crohn’s disease may require surgical procedures to correct strictures, inflammation, abscesses, or other problems with the intestines that require correction. When possible, a doctor
Enhancing nutrition can help to reduce a loss of lean muscle mass that can otherwise occur in people with Crohn’s disease. Improving a person’s nutrition with enteral nutrition may help them feel stronger and recover better after surgery.
Malnourished people with Crohn’s disease may have low albumin levels. Albumin is a protein that helps the body maintain fluid balance and process medications.
While enteral diets can be very beneficial for reducing information in people with Crohn’s disease, they can be difficult to follow and stick with. The enteral feedings may not taste good to some people. Also, a person may get tired of weeks of consuming similar formulas. If they have a feeding tube in their nose, this may be difficult for them to tolerate as well.
To improve their experience of the enteral nutrition diet, a person can try the following:
- Consider a partial enteral nutrition diet where they get at least 50% of their calories from food and the rest from the enteral diet.
- Drink other fluids sources (with a doctor’s permission) that are better-tasting. Examples include popsicles, broth, sports drinks, or gelatin.
- Ask their doctor or dietitian about adding in flavorings to make enteral formulas easier to consume.
A person must always first discuss any dietary changes they are considering with their doctor. If they are finding this diet difficult, a doctor will be able to recommend personalized ways that a person or child can better adapt to it.
Polymeric diets are enteral diets that incorporate special proteins. The proteins are usually easier to digest and may taste better than other enteral nutrition formulas.
Enteral diets can be more likely to promote remission of Crohn’s symptoms than polymeric diets.
The adherence rate, which is how well people follow the diet, is
Some people may not get the necessary proteins or nutrients from a polymeric diet, which is why a doctor may prescribe another enteral diet option.
Other nutritional options for Crohn’s disease include the following:
- Anti-inflammatory diet: Eating a diet low in inflammatory compounds can help to reduce flare-ups. Examples include avoiding processed foods.
- Parenteral nutrition: This involves administering nutrients and calories intravenously. This approach may help people who are very ill, such as in a severe flare-up.
- Low-fiber diet: During a flare-up, a doctor may recommend avoiding high-fiber foods as they may make stomach pain worse. Foods to avoid would include fruits and vegetables with the skins on.
- Plant-based diet: When a person’s Crohn’s disease is in remission, a doctor may recommend a plant-based, high-fiber diet.
Researchershave linked eating this type of diet with enhanced remission of peoples’ diseases.
But these diets are no replacement for medical treatment, such as biologic drugs. Studies that have looked at the effect of certain diets on Crohn’s disease are small, few, and may not be reliable.
A doctor may also make different dietary recommendations based on the way a person’s disease progresses.
Enteral diets involve a person receiving the nutrition they need through a drink or feeding tube. It can reduce inflammation and enhance nutrition in those with Crohn’s disease. It is a first-line treatment in children, and its effect on adults with Crohn’s disease is an area of exploration.
Some people may have difficulty following the diet due to taste concerns. A person should always talk with their doctor about ways to make their diet more manageable for the benefit of their overall health.