Symposium on the treatment of inflammatory bowel disease in children and adolescents. Nutritional therapy.

Malnutrition contributes substantially to the severity and morbidity of inflammatory bowel disease in children. Causes of malnutrition include decreased oral intake, excessive nutrient losses, increased nutritional requirements and malabsorption. Nutritional therapy is used to correct specific deficiencies, delayed growth and puberty, and as primary therapy to achieve total bowel rest in patients with disease that is resistant to conventional medical treatment. Total parenteral nutrition has been used successfully in patients with nonfistulous Crohn's disease and in those with retarded growth. Results are not as encouraging in patients who have Crohn's disease with fistula and in patients with ulcerative colitis. Continuous elemental enteral nutrition seems promising, but more controlled studies are needed to assess critically the value of this form of therapy.