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Diet Avoids Steroid Use in Children with Crohn's Disease: Presented at DDW

By Roberta Friedman

SAN FRANCISCO, CA -- May 20, 2002 -- Diet as a first line treatment can help avoid the need for steroid therapy in children with Crohn's disease, suggest results presented here on May 19 at the 103^rd annual meeting of the American Gastroenterological Association and Digestive Disease Week (DDW).

Dr. Bhupinder Sandhu of the Bristol Royal Hospital for Sick Children, in Bristol, England, said that elemental or polymeric feeds can be as effective as steroids in bringing on remission. The long-term study showed that 21 of 44 children could avoid any use of steroids, and steroid use was delayed by a median of 68 weeks in the remainder of the children.

Forty children in the study had elemental diet and four had polymeric feeding. Oral use was possible in 12, but 32 had nasogastric tube feeding. Ten percent of the patients (four children) did not respond to the diet change and took steroids. Median time to remission was six weeks. Duration of remission was a median of 54 weeks.

Seventeen patients have not relapsed and have never taken steroids, Dr. Sandhu said. Relapses occurred in 27 patients; 16 of these were treated with elemental diet, and 12 of these achieved remission. No differences in the groups were apparent -- the sicker ones did not tend to choose steroid use. Those with upper gastrointestinal involvement tended to take longer to relapse. A total of 21 patients (47 percent) were never treated with steroids and the remainder delayed their use of steroids by a median of 68 weeks (range 6-190 weeks).

Dr. Sandhu said that further studies of the use of elemental feeding should look at growth rates and bone density in the children compared to those given steroids.

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