Which form of nutrition is recommended as first-line therapy in pediatric Crohn's disease?

• A. Elemental Enteral Formula
• B. Exclusive Enteral Nutrition
• C. Parenteral Nutrition
• D. Gluten-Free Diet

Answer: (B)

In pediatric Crohn's disease, starting with exclusive enteral nutrition is recommended to induce remission. This means using a complete liquid formula as the sole source of nutrition for a set period, typically about 6 to 8 weeks, with careful monitoring and reintroduction of foods afterward.

Why this is the best pick: trials in children show that exclusive enteral nutrition can achieve remission rates comparable to corticosteroids, but with the added benefits of supporting growth, providing balanced nutrition, and avoiding the growth-suppressing and systemic side effects associated with steroids. The formula also reduces intestinal inflammation and promotes mucosal healing, which are important in children who are still growing and developing. Because it keeps the gut clean of regular food antigens during the inflammatory phase, it can shorten disease activity and improve nutritional status.

Why not the other options: parenteral nutrition is used when the gut cannot be used at all or in severe cases where enteral feeding isn’t possible or safe; it bypasses the gut and doesn’t promote mucosal healing in the way enteral nutrition does, so it isn’t first-line for induction. gluten-free diet isn’t demonstrated as a universal first-line therapy for Crohn’s disease in children and lacks the robust evidence supporting it as an induction approach. Elemental formulas exist but are not uniquely superior to polymeric formulas for induction in most pediatric cases and are often less palatable and more costly, making exclusive enteral nutrition with a standard formula the more practical first choice.