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Crohns sykdom, medisinsk behandling: Eksklusiv enteral ernæring (EEN)

Særlig hos barn har man hatt svært god effekt av eksklusiv enteral ernæring (EEN). Denne behandlingen går ut på at pasienten ikke spiser vanlig mat, men får dekket hele næringsbehovet gjennom flytende næringsløsninger (sondemat). Selv hos barn med relativt alvorlig og utbredt sykdom, har denne behandlingen vist effekt på linje med, eller bedre enn, steroider. Det har også vist seg at dersom denne behandlingen virker, vil slimhinnen tilheles. Steroider har en tendens til å lindre de akutte plagene, men de fører bare i liten grad til tilheling av slimhinnen. EEN har best effekt på pasienter med sykdom i tynntarm og tykktarm, men behandlingen virker sannsynligvis dårligere på sykdom i endetarmsområdet.

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Behandlingen varer som regel i 6 uker. Dersom man ikke har hatt effekt i løpet av de første 3 ukene, avbrytes vanligvis behandlingen. Etter 6 uker med EEN, kan man spise vanlig mat. I noen tilfeller fortsetter man med å gi halvparten av næringsbehovet som sondeernæring og den andre halvparten som vanlig mat. Det er usikkert hvor godt dette forebygger nye tilbakefall. Hvorfor denne behandlingen fungerer, vet man ikke.

Behandlingen kan være vanskelig å gjennomføre, og den krever at man er motivert. Savnet etter mat er nok det største problemet. Vanligvis gjennomføres behandlingen ved å føre en tynn sonde (plastslange) gjennom nesen og videre bak i svelget ned gjennom spiserøret til magesekken. Dersom man velger å drikke næringsløsningene selv, blir de fleste lei av det begrensede utvalget av smaker. Sonden kan man lære seg å legge selv, og det er fullt mulig å drikke litt næringsløsninger selv på dagtid på skole/jobb og legge ned sonde når man kommer hjem for å klare å få i seg resten av næringsløsningene.

Dette dokumentet er basert på det profesjonelle dokumentet Crohns sykdom . Referanselisten for dette dokumentet vises nedenfor

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