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Background: Exclusive enteral nutrition (EEN) is a first‐line treatment for Crohn's disease in paediatrics with similar efficiency to corticosteroids. Benefits in adults have not been consistently observed with non‐adherence cited as a limiting factor. This study aimed to gain an in depth understanding of the adult patient experience with EEN, identifying challenges and enablers to inform clinicians in the development of strategies to help increase patient adherence. Methods: This exploratory, qualitative study utilised individual semi‐structured interviews with 17 adult patients who had completed EEN. Participants were purposively recruited across a range of ages, social backgrounds and clinical experience. Interviews were audio recorded, transcribed and independently thematically analysed by two researchers to provide consensus in identifying key themes. Results: Three major themes were identified. (i) Personal experience of EEN evolved over time, with the first few weeks the most challenging, becoming easier as symptoms improved, and participants became used to the EEN regimen. (ii) Participants developed coping strategies to manage challenges, including the impact on meal‐based social participation and dietary restriction and monotony. (iii) Enabling factors for adherence to EEN included patient self‐efficacy, health system support, supplement characteristics and access, and social support. Conclusions: This study explored the evolving experiences of patients who completed a prescribed course of EEN. Patients described the challenges they faced, how they overcame them identifying enablers for adherence. This provides useful strategies for clinicians to integrate in their assessments and share with patients starting EEN. [ABSTRACT FROM AUTHOR]

Rhizoctonia muneratii ATCC 13247 was capable of catalyzing the conversion of 25-hydroxycholesterol to the 3-oxo-4-ene. Hydroxylation at the 6alpha and 6beta positions with the concomitant 3-oxo-4-ene transformation was also observed. The addition of Triton X-100 to the growth medium immediately before steroid addition selectively prevented the appearance of the respective 6alpha-hydroxylated products. The observed conversions were indicative of the utility of microbial transformations in preparing hydroxylated steroids which can be useful for further synthetic modification or for study as pharmacological agents.