Effectiveness of concomitant enteral nutrition therapy and infliximab for maintenance treatment of Crohn's disease in adults.

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kiny

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It's not super recent, just posting it for the record really since it's open access.

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Kiny - thanks so much for posting!

What are your thoughts as to why supplemental EN together with remicade helps in maintaining remission?

And, do you think that, once in remission, ingesting any nutritional shake would have the same benefits (ie Boost or Ensure rather than a full elemental formula)?

Thanks
 
I dunno. They have no idea if EN works why it works.

there's many theories:

-it's a nutritional therapy, it restores deficiencies which decreases gut permeability
-it modulates the inflammatory response
-it modulates the intestinal flora
-it's because it uses medium chain triglycerides
-it's because it is extremely low in microparticles

they don't really know

As far as Boost and Ensure. Boost and Ensure (and Fortimel / Fortisip etc) are very very different from 028, Modulen etc.

They don't have the same type of bioavailable whey proteins like hydrolised whey, they don't use the same type of dried glucose that EN tend to use, they use other types of fats than medium chain triglycerides. I don't know what is all in Boost and Ensure, but it's not comparable to "real" EN. They're really low quality products in my opinion. That's also why they're considerably cheaper, if EN is cheap it's probably not any good, isolating whey without denaturing is an expensive process, it can't be done on the cheap.
 
Thanks Kiny. Even though my son is now on remicade and is very near to biochemical remission (I think), I would like him to continue with some form of EN. But, unfortunately, I will have to find some balance between the benefits of nutrition, the cost and the taste (which will effect compliance).
 

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