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We recently met with the family of Zach K., an impressive young man living with Crohn’s disease. This is a condition that leads to inflammation in the GI tract. Encouraged from an early age to take part in his own treatment, Zach learned how to insert his own feeding tube and uses Peptamen® formula, a specialized nutritional formula from Nestlé Health Science. We talked to Aimee Henrikson, Registered Dietitian and Pediatric Medical Scientific Liaison for Nestlé Health Science, about Crohn’s disease and the important role of nutritional therapy.
Q&A: Crohn’s Disease

What is Crohn’s disease?

Q&A: Crohn’s Disease

Crohn's disease is a chronic inflammatory condition of the gastrointestinal, or GI, tract. It can happen in any part of the GI tract, but it most commonly affects the end of the small bowel, which is called the ileum, where the colon begins.

Q&A: Crohn’s Disease

 

Q&A: Crohn’s Disease

People often talk about Crohn’s and ulcerative colitis in the same breath. What’s the difference?

Q&A: Crohn’s Disease

While Crohn's can affect any section of the GI tract, ulcerative colitis (UC) only appears in the colon. Also, Crohn’s disease can impact the entire thickness of the bowel wall. With UC, only the inner-most lining of the colon is affected.

Q&A: Crohn’s Disease

Could you tell us a little more about the causes of Crohn’s disease?

Q&A: Crohn’s Disease

The causes of Crohn's are not well understood. Inflammation and the immune system play a role. The immune system can be triggered by environmental factors such as bacteria, a virus or some other unidentified factor in the environment. When the immune system is triggered, it affects the GI tract, causing inflammation that contributes to symptoms. We also know that there's a genetic component and that diet and stress may play a role.

Q&A: Crohn’s Disease

What are the symptoms of Crohn’s disease and are they any different for a child versus an adult?

Q&A: Crohn’s Disease

Symptoms include diarrhea, rectal bleeding, and an urgent need to go to the bathroom. Abdominal cramping and chronic constipation can lead to bowel obstruction in the affected person’s GI tract. In children, there may be a delay in growth and development as the result of the disease.

Q&A: Crohn’s Disease

What are the options for Crohn’s disease?

Q&A: Crohn’s Disease

There are medications that suppress the immune system, which are meant to reduce inflammation and symptoms in the GI tract. However, suppressing the immune system can cause other complications. Surgery to remove part of the GI tract is an option, although symptoms can still return. Another way to help manage Crohn’s is with enteral nutritional therapy, which Zach has been on most of his life.

Q&A: Crohn’s Disease

Sounds like Zach and his family are big fans of enteral nutritional therapy. What was their experience?

Q&A: Crohn’s Disease

Zach’s doctors tried several medications, some of which caused side effects and ultimately didn’t resolve his symptoms. Once he started enteral nutritional therapy, his family saw a big improvement, and it’s how his condition has been managed since he was five. Of course, everyone is different, and people with Crohn’s should work with their doctors to determine what’s right for them.

Q&A: Crohn’s Disease

Zach got his nutritional therapy through a nasogastric tube. Could you give us some background on this?

Q&A: Crohn’s Disease

When you get your nutrition through a tube, it’s called enteral nutrition. Zach used a nasogastric tube, which goes through the nose into the stomach. Studies have shown that enteral nutrition can help replace nutrients that are depleted due to Crohn’s. And, exclusive enteral nutrition has been shown to be effective in the dietary management of pediatric patients with Crohn’s disease.1

Q&A: Crohn’s Disease

Zach’s mother mentioned that Zach used Peptamen® formula for nutritional support. Could you tell us more about it?

Q&A: Crohn’s Disease

Sure. Peptamen® formula contains protein that has been broken down or hydrolyzed into smaller protein fragments known as peptides. It is made from 100% whey and also contains a special kind of fat called medium-chain triglycerides (MCT) which help to facilitate fat absorption. You should consult your child’s healthcare professional to determine the most appropriate nutritional regimen.

Want to learn more about enteral nutrition and tube feeding?

Get information and resources on tube feeding for adults or tube feeding for children.

Reference:

  1. Critch J, et al. Use of enteral nutrition for the control of intestinal inflammation in pediatric Crohn’s disease. JPGN 2012;54:298-305.