Skip to main content
IBDNutrition
Back to home

Important clinical notice: This tool is for informational purposes only and is based on cited scientific publications. It does not replace consultation with your specialist medical team. Any dietary intervention must be supervised by a gastroenterologist and/or registered dietitian.

Exclusive Enteral Nutrition

What is EEN?

Remission induction · 6–8 weeks

What is EEN?

Exclusive Enteral Nutrition (EEN) is a nutritional therapy that consists of delivering 100% of daily caloric and protein requirements through a liquid enteral formula, completely excluding the usual solid diet.

Recommended duration

Typically between 6 and 8 weeks for the remission induction phase.

[1][2]

Paediatric Indications

1st line

It is the first-line treatment to induce clinical remission in children and adolescents with active luminal Crohn's Disease.

Key benefits

  • High rates of mucosal healing.
  • Improvement of bone density and promotion of catch-up growth.
  • Avoids the adverse effects associated with corticosteroids.

[2][3]

Limitations of EEN and the CDED Alternative

Although EEN is highly effective, its main clinical limitation is poor patient adherence due to palate fatigue and the psychosocial impact of completely excluding solid foods for several weeks.

The validated alternative

To address this, the Crohn's Disease Exclusion Diet (CDED) combined with Partial Enteral Nutrition (PEN) was developed. Clinical trials demonstrate that CDED + 50% PEN is non-inferior to EEN for inducing remission, while showing significantly better tolerance and adherence, making it a more realistic first-line alternative for many patients.

[1]

Strategic Use in Adults

Although it is not the universal first-line treatment to induce remission in adults, it is strongly indicated in specific scenarios according to ECCO guidelines:

  • Pre-surgical nutritional optimisation.
  • Patients refractory to medical treatment or with contraindication to corticosteroids.
  • Management of complications (e.g. non-fibrotic inflammatory strictures).

[4]

Use the IBDNutriCalc calculator to compute a personalised Exclusive Enteral Nutrition plan (EEN mode) for your patient.

Open IBDNutriCalc →

Bibliographic References

  1. [1]

    Levine A, Wine E, Assa A, et al. Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial. Gastroenterology. 2019;157(2):440-450.e8. PMID: 31170412

  2. [2]

    Ruemmele FM, et al. (ECCO/ESPGHAN). Consensus guidelines of ECCO/ESPGHAN on the medical management of paediatric Crohn's disease. J Crohns Colitis. 2014;8(10):1179-1207. PMID: 24909831

  3. [3]

    Van Rheenen PF, et al. (ECCO-ESPGHAN). The Medical Management of Paediatric Crohn's Disease: an ECCO-ESPGHAN Guideline Update. J Crohns Colitis. 2021;15(2):171-194. PMID: 33026087

  4. [4]

    Lamb CA, et al. (British Society of Gastroenterology). British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019;68(Suppl 3):s1-s106. PMID: 31562236