Nutritional Support Therapy
Symptoms of inflammatory bowel disease (IBD) can sometimes make it difficult for you to get enough calories and nutrition from food and supplements alone.
Your healthcare provider may recommend nutritional support therapy when IBD complications, such as weight loss, surgery, obstruction, or severe inflammation, prevent you from getting the right nutrients.
We can help you understand the different types of nutritional support and how they work to keep you as healthy as possible.
Enteral nutrition, or EN, is a way to give your body what it needs to stay healthy. “Enteral” means passing through the intestines. Enteral nutrition is usually taken in the form of a nutrient-rich formula which can either supplement your caloric intake or stand in as your main source of nutrition. Some common formulas you may have seen include Boost, Ensure, and Orgain.
Most enteral liquids contain all the proteins, carbohydrates, fats, minerals, and vitamins necessary to sustain you, even if you are not eating at all. Enteral nutrition also helps protect or improve your small intestine’s ability to absorb nutrients.
You can drink an enteral nutrition formula or it can be ingested through a feeding tube.
Common types of feeding tubes:
A nasogastric tube (NG tube) is placed through one of your nostrils and travels down to your stomach.
A nasoduodenal tube (ND tube) or nasojejunal tube (NJ tube) is placed through one of your nostrils down into portions of your small intestine.
Gastronomy tube (G-tube) or jejunostomy tube (J-tube) is put directly into your stomach or intestine through a surgical incision into your skin.
Depending on the severity of your disease or its symptoms, your doctor has choices as to how much formula you may need to consume to stay healthy.
Partial enteral nutrition, or PEN, means you receive between 30 and 50% of your calories from formula and the remainder from regular food.
Exclusive enteral nutrition, or EEN, means you receive all of your calories through formula and you do not eat regular food. EEN has been proven to induce remission in children with Crohn’s disease, and is a popular pediatric therapy in Western Europe.
Parental nutrition, or PN, delivers necessary nutrients and calories directly into your bloodstream through a thin intravenous tube called a catheter that is inserted directly into a large vein in the chest, arm, or neck. “Parenteral” means outside of the digestive system.
Parenteral nutrition is used when your gut is not working and you are unable to absorb any nutrients you try to consume.
Potential complications requiring parenteral nutrition:
An extremely severe flare
Bowel perforation or fistula
Your nutrition needs to improve before surgery
If you’ve developed short bowel syndrome after multiple surgeries to remove portions of your small intestine