[Significance of elemental diets in the therapy of Crohn disease in childhood].

Aminoacid and oligopeptide formulas of low molecular weight have frequently been used in the past on an empirical basis for nutritional support of patients with Crohn's disease. Improvement of intestinal symptoms and laboratory parameters reflecting the inflammatory process have been demonstrated. Only a few controlled therapeutic trials have compared elemental diets with conventional drug therapy. In small bowel involvement, therapeutic efficiency in active disease is as good as salazosulfapyridine combined with corticosteroids. Elemental diet is less effective in large bowel disease. In the therapeutic application of elemental diets in active disease these formulas should be the only nutritional source for the patient. Particularly in small bowel disease the growth retarding side effects of corticosteroids can markedly be reduced by elemental diets. Children with moderate disease and additional growth retardation may benefit from either supplemental elemental diet and/or high molecular weight formula or from parenteral hyperalimentation. --Crohn-specific fistulas seem to close rarely on elemental diets while favourable results are seen in postoperative fistulas.