Exclusive Enteral Nutrition

Exclusive Enteral Nutrition Introduction

Exclusive Enteral Nutrition (EEN) involves the exclusive use of a liquid diet with no solid food for 6-8 weeks, sometimes up to 12 weeks, usually with the goal of inducing remission. Exclusive enteral nutrition can be administered orally with over-the-counter meal-replacement formulas. For those who find it difficult to drink the required amount of formula, a nasogastric tube may be used to make the process easier. It is important to work with your medical team and dietitian when using EEN to be sure that all caloric and nutritional needs are met.

EEN is the Foundation for Nutritional Therapy

The recognized efficacy of EEN is the foundation for investigating the potential of other dietary therapies for IBD. If EEN can provide these benefits with a liquid diet, is it possible to induce remission or to maintain it with a whole-foods diet? Part of the answer may lie in the proposed mechanisms for its efficacy, which include the exclusion of harmful substances, giving the bowel rest, providing essential micronutrients that are easily absorbed, and modulating the microbiome.

Some of the underutilization of EEN in the US may be explained by the fact that there has not been an established transition from EEN to a dietary maintenance therapy. A return to a liberalized diet results in rapid increases in inflammation and high relapse rates. Partial enteral nutrition (PEN) as sole therapy following EEN is ineffective long term but has been shown to help maintain remission when combined with medications (see Partial Enteral Nutrition). Although there is not yet an established single dietary recommendation, following EEN with another dietary therapy may improve chances of maintaining remission, compared with a transition to PEN alone or a return to a liberalized diet.