Nutrition care and dietetic resources in pediatric inflammatory bowel disease: An initiative of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Porto Group and Special Interest Group.

OBJECTIVES

Dietary therapy is often used in the management of children with inflammatory bowel diseases (IBD). Nevertheless, appropriate dietetic support and resources are not universally available, potentially leading to variable practices. This survey aimed to describe contemporary dietary practices and resourcing across IBD member centers of European Society of Paediatric Gastroenterology Hepatology & Nutrition (ESPGHAN).

METHODS

An anonymous 33-item questionnaire survey on nutritional care and dietetic resources was circulated to the Porto Group and IBD Interest Group of ESPGHAN in November 2023.

RESULTS

We obtained responses from 63/145 (43%) physicians from 31 countries. Fifty-four (86%) physicians, routinely use exclusive enteral nutrition (EEN) for induction of remission, 26/63 (41%) partial enteral nutrition (PEN) for maintenance of remission and 28 (44%) implement food-based dietary therapies, the most popular being Crohn's Disease (CD) exclusion Diet coupled with PEN 36 (61%). Notably, 41 (65%) reported offering dietary counseling for active CD compared to 20 (32%) for ulcerative colitis (UC, p = 0.005). Availability of a dietitian varied between centers, with 13 (21%) rarely or never having a dietitian available. Among sites where a dietitian was always or mostly available, 93% used EEN compared to 70% of sites where a dietitian was less available (p = 0.028). Access to dietitians was reported for 31% of CD patients in lower-income countries versus 66% in high-income countries (p = 0.015). Over 50% of CD patients sought dietary advice, compared to 41% of UC patients (p < 0.001).

CONCLUSIONS

We identified variable practices in nutritional therapy and dietetic resources among pediatric IBD centers. Addressing these challenges will improve IBD therapy and integrate nutritional therapies in the multi-disciplinary care of these patients.