Intest Res  
Japanese physicians’ attitudes towards enteral nutrition treatment for pediatric patients with Crohn’s disease: a questionnaire survey
Takashi Ishige1, Takeshi Tomomasa2, Hitoshi Tajiri3, Atsushi Yoden4; on behalf of the Japanese Study Group for Pediatric Crohn’s Disease
1Department of Pediatrics, Gunma University Graduate School of Medicine, Maebashi, 2PAL Children’s Clinic, Isesaki, 3Department of Pediatrics, Osaka General Medical Center, Osaka, 4Department of Pediatrics, Osaka Medical College, Takatsuki, Japan
Correspondence to: Takashi Ishige, Department of Pediatrics, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Japan. Tel: +81-27-2208205, Fax: +81-27-2208215, E-mail:
Received: September 17, 2016; Revised: November 22, 2016; Accepted: December 1, 2016; Published online: March 31, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background/Aims: Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn’s disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices. Methods: Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians’ attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011. Results: A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days. Conclusions: EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.
Keywords: Crohn disease; Food, formulated; Enteral nutrition; Child; Surveys and questionnaires

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