Introduction
This page will tell you about Exclusive Enteral Nutrition (EEN). It will answer some questions you may have about it.
What is Crohn’s disease?
Crohn’s disease can affect any part of your gut. It causes inflammation, ulcers, swelling and soreness on the lining of your gut.
When symptoms are under control, it is known as remission. When symptoms are more active, it’s called a flare-up.
Crohn's disease is a lifelong illness. It currently has no known cure. However, medications, surgery, or a mix of the two can help you stay well.
Symptoms of Crohn’s disease can include:
- Feeling tired.
- Diarrhoea.
- Blood in your poo.
- Constipation.
- Bloating and wind.
- Tummy pain.
- Joint problems and/or weaker bones.
What is EEN?
It is a liquid only diet. The aim is to put your Crohn’s into remission or to reduce your symptoms. The diet is followed for a short time of 6-8 weeks.
It replaces all food and most drinks with prescribed drinks. These drinks will provide all you need to stay healthy. These drinks come in a range of flavours. Your dietitian will tell you how many drinks you need.
We don’t fully know how it works. One idea is that it helps the gut ‘rest’. Some studies have shown it works for 45-75% of patients.
Sometimes you will need to follow it if you have a narrowing in your gut called a stricture. Your doctor will tell you if you have this.
How long will I need to follow EEN?
- It should usually be followed strictly for 6-8 weeks. This depends on your response.
- Once you start to eat food again, you may need to continue some of the drinks. Your dietitian will advise on this.
My target for EEN
| Name of Nutrition drink(s) | Number of drinks per day |
|---|---|
| E.g. Fortisip | 6 |
- Extra fluid you need:
- Provides:
- kcal:
- g of protein:
- ml fluid:
Following this diet can be hard! Here are some tips to make it easier:
- Freeze your drinks into ice lollies.
- Try lots of flavours. Your dietitian can discuss this with you.
- Spread your drinks throughout the day.
- Sip on the drinks slowly to make them last longer.
Contact your dietitian if you can’t finish all your drinks.
How do I know if EEN is working?
The treatment goal includes:
- Remission.
- Normal bloods.
- Healing of your gut.
- Better quality of life.
We can use The Harvey-Bradshaw Index to see if the diet is working.
This table is at the back of the sheet for you to fill out. Please fill it out before, during, and after your diet.
If you have an appointment with a dietitian, please take this completed with you.
What happens after your EEN diet?
After following EEN for a minimum of 6 weeks, you can slowly reintroduce food over 5 days. This is an example based on a total based on total 2400kcal.
- Day 1 - breakfast, 7 nutritional drinks.
- Day 2 - breakfast, lunch, 5 nutritional drinks.
- Day 3 - breakfast, lunch, dinner, 3 nutritional drinks.
- Day 4 - breakfast, mid-morning snack, lunch, afternoon snack, dinner, 1 nutritional drink.
- Day 5 after EEN - follow your normal diet. You may need to continue the nutritional drinks for weight gain or support. You can discuss this with your dietitian.
Going forward
There is no specific diet you need to follow when your Crohn’s is in remission. No diet has been proven to help keep you in remission. Also, no foods can cause flare-ups. Some foods may trigger symptoms, but they can’t cause a flare-up. If that happens, use the food and symptom diary at the back of this booklet. It may help you spot trigger foods when you are in remission.
Key points for diet in remission
- Aim for a healthy, balanced diet that gives you all the nutrients you need to stay healthy.
- Avoid cutting out foods or food groups, as you would miss out on important nutrients.
- Try to eat a variety of fruits, vegetables, nuts, seeds, proteins, and whole grains.
- Limit high-fat, high-sugar, and high-salt foods, especially animal fats and processed meats.
- You don't need to cut back on fibre unless you have a narrowing in your gut (called a stricture).
Always talk to your GP, IBD team, or dietitian before making major changes to your diet.
Harvey-Bradshaw Index for Crohn’s
Please fill out this form on day 1 of starting the EEN diet. It is useful to bring this completed if you are due to see a Dietitian. If you are unsure what each section means, please speak to your clinician.
| Week | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
|---|---|---|---|---|---|---|---|---|
| Your general wellbeing (for previous day) 0 = very well 1 = slightly below par 2 = poor 3 = very poor 4 = terrible | ||||||||
| Abdominal pain (for previous day) 0 = none 1 = mild 2 = moderate 3 = severe | ||||||||
| Number of liquid stools per day (for previous day) Score 1 per movement | ||||||||
| Abdominal mass 0 = none 1 = dubious 2 = definite 3 = definite and tender | ||||||||
Complications (score 1 per item)
| ||||||||
| Total: Remission: less than 5 Mild disease: 5-7 Moderate disease: 8-16 Severe disease: more than 16 |
Food and symptom diary
Use this template for any day of the week.
| Day: | Food | Symptoms | Time of day and how long symptoms lasted |
|---|---|---|---|
| Breakfast | |||
| Mid-morning snack | |||
| Lunch | |||
| Mid-afternoon snack | |||
| Dinner | |||
| Notes |
© North Bristol NHS Trust. This edition published February 2026. Review due February 2029. NBT003821