{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:04:31Z","timestamp":1792069471472,"version":"4.4.0"},"reference-count":182,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T00:00:00Z","timestamp":1568419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Medical and surgical treatments for Crohn\u2019s disease are associated with toxic effects. Medical therapy aims for mucosal healing and is achievable with biologics, immunosuppressive therapy, and specialised enteral nutrition, but not with corticosteroids. Sustained remission remains a therapeutic challenge. Enteral nutrition, containing macro- and micro-nutrients, is nutritionally complete, and is provided in powder or liquid form. Enteral nutrition is a low-risk and minimally invasive therapy. It is well-established and recommended as first line induction therapy in paediatric Crohn\u2019s disease with remission rates of up to 80%. Other than in Japan, enteral nutrition is not routinely used in the adult population among Western countries, mainly due to unpalatable formulations which lead to poor compliance. This study aims to offer a comprehensive review of available enteral nutrition formulations and the literature supporting the use and mechanisms of action of enteral nutrition in adult Crohn\u2019s disease patients, in order to support clinicians in real world decision-making when offering\/accepting treatment. The mechanisms of actions of enteral feed, including their impact on the gut microbiome, were explored. Barriers to the use of enteral nutrition, such as compliance and the route of administration, were considered. All available enteral preparations have been comprehensively described as a practical guide for clinical use. Likewise, guidelines are reported and discussed.<\/jats:p>","DOI":"10.3390\/nu11092222","type":"journal-article","created":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T03:17:57Z","timestamp":1568603877000},"page":"2222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Enteral Nutrition in Adult Crohn\u2019s Disease: Toward a Paradigm Shift"],"prefix":"10.3390","volume":"11","author":[{"given":"Simona","family":"Di Caro","sequence":"first","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7677-7989","authenticated-orcid":false,"given":"Konstantinos C.","family":"Fragkos","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Keetarut","sequence":"additional","affiliation":[{"name":"Department of Dietetics, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Fen","family":"Koo","sequence":"additional","affiliation":[{"name":"UCL Medical School, 74 Huntley Street, Bloomsbury, London WC1E 6DE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5422-323X","authenticated-orcid":false,"given":"Gregory","family":"Sebepos-Rogers","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajeena","family":"Saravanapavan","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Barragry","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Rogers","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shameer J.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farooq","family":"Rahman","sequence":"additional","affiliation":[{"name":"Intestinal Failure Service, GI Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies","volume":"390","author":"Ng","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S2468-1253(16)30077-2","article-title":"Globalisation of inflammatory bowel disease: Perspectives from the evolution of inflammatory bowel disease in the UK and China","volume":"1","author":"Kaplan","year":"2016","journal-title":"Lancet Gastroenterol. 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