Liquid diets for Crohn's disease.

Enteral diets: primary therapeutic role In the early 1970s, disease modifying eVects of an elemental diet in Crohn’s disease (CD) were observed. The first controlled study in 1984 confirmed that an elemental diet was as eVective as steroids in inducing remission in acute CD. Several subsequent studies supported this primary therapeutic eVect for both elemental and polymeric enteral diets (see review). Pooling the data however has shown a less favourable outcome with three meta-analyses similarly concluding that corticosteroids were more eVective 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. In addition to therapeutic eVect, liquid diets for acute CD oVer an unrivalled safety profile and significant nutritional benefits. We consider these diets as ideal therapy in paediatric CD, especially in the presence of malnutrition or growth impairment, and in patients with severe drug induced side eVects. Patients with CD typically relapse in the longer term, irrespective of the therapeutic approach, and therefore maintenance and retreatment strategies for diet induced remission should be more fully investigated.