Enteral diets: primary therapeutic role

In the early 1970s, disease modifying effects of an elemental diet in Crohn's disease (CD) were observed. The first controlled study in 1984 confirmed that an elemental diet was as effective as steroids in inducing remission in acute CD.1 Several subsequent studies supported this primary therapeutic effect for both elemental and polymeric enteral diets (see review2). Pooling the data however has shown a less favourable outcome with three meta-analyses similarly concluding that corticosteroids were more effective than enteral diet therapy. A heterogeneous study mix may not be representative of the clinical situation. Data, from a single centre spanning 10 years of enteral diet therapy supported remission rates equal to that of drug therapy.3 …