Primerjava izključne in delne enteralne prehrane pri zdravljenju Crohnove bolezni pri otrocih

Rupnik, Sandra (author), Benedik, Evgen (mentor)

Crohnova bolezen (CB) je kronična, ponavljajoča se, vnetna bolezen, ki lahko prizadene vse dele in sloje prebavne cevi ter predstavlja eno glavnih oblik kronične vnetne črevesne bolezni. Zdravila za popolno ozdravitev CB zaenkrat še ni, zato je osnovni namen zdravljenja doseganje remisije bolezni. Po uradnih priporočilih Evropskega združenja za pediatrično gastroenterologijo, hepatologijo in prehrano se kot prvo terapijo pri zdravljenju otrok uporabi prehransko terapijo z izključno enteralno prehrano (IEP) za čas šest do osem tednov. Omenjena terapija je za bolnike pogosto psihično naporna, saj tekom šestih tednov uživajo vsak dan isto količino enteralnega pripravka s konstantno enakim okusom, konsistenco in barvo, ob tem pa ne smejo uživati drugega kot vodo. Z raziskavo smo želeli ugotoviti, kakšne učinke ima omenjena IEP v primerjavi z delno enteralno prehrano (DEP), ki naj bi bila za bolnike lažja, saj jim deloma omogoča tudi klasično hranjenje, kar naj bi ugodno vplivalo na sodelovanje bolnikov. Hkrati nas je zanimalo, kakšne so bile sociodemografske značilnosti bolnikov in kakšne prehranske navade so imeli pred boleznijo ter ali so se le-te po zdravljenju spremenile. V raziskavi je sodelovalo 22 bolnikov mlajših od 18 let z aktivno obliko CB. Eno skupino bolnikov smo zdravili z IEP, drugo z DEP v kombinaciji s protivnetno dieto. Po končani prehranski terapiji smo evalvirali klinično stanje bolnikov in ugotovili, da sta bili obe terapiji enako učinkoviti in da je 82 % bolnikov obeh skupin doseglo klinično remisijo. Pri ugotavljanju, katera terapija je bila bolnikom lažja, nismo našli razlik, smo pa ugotovili, da je DEP 17 % manj bolnikom povzročala slabost. Ugotovili smo tudi, da so otroci s CB tekom zdravljenja spoznali načela zdravega prehranjevanja, ki so jim bila predstavljena s strani kliničnega dietetika. Klinični vpliv IEP in DEP je bil torej enak, medtem ko je bila za bolnike lažja prehranska terapija z DEP.

• Language: Slovenian
• Keywords: prehrana, dietna prehrana, izključna enteralna prehrana, delna enteralna prehrana, Crohnova bolezen, otroci
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: BF - Biotechnical Faculty
• Publisher: [S. Rupnik]
• Year: 2020
• PID: 20.500.12556/RUL-113718
• UDC: 613.2-053.2:616.34-002
• COBISS.SI-ID: 5152376
• Publication date in RUL: 29.01.2020

RUPNIK, Sandra, 2020, Primerjava izključne in delne enteralne prehrane pri zdravljenju Crohnove bolezni pri otrocih [online]. Master’s thesis. S. Rupnik. [Accessed 15 April 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=113718

Secondary language

• Language: English
• Title: Comparison of exclusive and partial enteral nutrition for treatment of crohn's disease in children.

Abstract

Crohn's disease (CD) is a chronic, inflammatory disease that can affect all parts and layers of the digestive tube and is one of the major forms of chronic inflammatory bowel disease. There is no cure for CD yet, so the primary purpose of treatment is to achieve remission. According to the official recommendations of The European Society for Paediatric Gastroenterology Hepatology and Nutrition, nutritional therapy with exclusive enteral nutrition (EEN) is used as the first line therapy in the treatment of children. Since the mentioned therapy is long-lasting and strenuous for many patients, as they consume the same amount of enteral preparation with constantly the same taste, consistency and colour every day for six weeks, while they can only add water, not many can go through with it. Therefore we wanted to compare it to partial enteral nutrition (PEN), which is supposed to be easier for patients, since it partially allows them to eat normal foods, which is expected to have a beneficial effect on patient participation. At the same time, we were interested in the socio-demographic and eating characteristics of patients and how their eating habits changed during treatment. The study involved 22 patients under the age of 18 with active form of CB. The first group of patients was treated with EEN and the second with PEN in combination with an anti-inflammatory diet. After treatment period, clinical analyses revealed that both therapies were equally effective and that 82 % of patients in both groups achieved clinical remission. We did not find any differences in identifying which therapy was easier for patients, but we found that PEN caused less nausea in 17 % patients. We also found that during the treatment of CD children learned the principles of healthy eating that were presented to them by clinical dietitian. Therefore the clinical impact of EEN and PEN was the same, while treatment with PEN was easier for patients.

• Keywords: nutrition, diet nutrition, exclusive enteral nutrition, partial enteral nutrition, Crohn's disease, children