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

• A. Parenteral nutrition
• B. Gluten-free diet
• C. Exclusive enteral nutrition (EEN)
• D. Standard diet

Answer: (C)

Exclusive enteral nutrition is used as first-line induction in pediatric Crohn’s disease because it can actively reduce intestinal inflammation and induce clinical remission while supplying complete, balanced nutrition that supports growth. In children, avoiding corticosteroids when possible is important due to growth and developmental risks; EEN achieves remission rates comparable to steroids but without these side effects, and it also promotes mucosal healing and improves nutritional status and linear growth. The approach involves a formula-only diet for about 6 to 8 weeks, with careful monitoring and then gradual reintroduction of regular foods after remission.

Parenteral nutrition bypasses the gut and is reserved for cases where the GI tract cannot be used or in severe malnutrition or obstruction; it does not address luminal inflammation in Crohn’s and carries risks like infections, so it isn’t used as the initial induction therapy.

Gluten-free diet is not a standard induction therapy for Crohn’s disease, as Crohn’s inflammation is not driven by gluten in most cases. A standard mixed diet, while appropriate for maintenance, does not actively induce remission.