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Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial (CDED)

Summary Excerpt: CDED plus PEN was better tolerated than EEN in children with mild to moderate CD. Both diets were effective in inducing remission by week 6. The combination CDED plus PEN induced sustained remission in a significantly higher proportion of patients than EEN, and produced changes in the fecal microbiome associated with remission. These data support use of CDED plus PEN to induce remission in children with CD.

Gastroenterology. 2019 Aug;157(2):440-450.e8. doi: 10.1053/j.gastro.2019.04.021. Epub 2019 Jun 4
Levine A et al

Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease (AIP)

Summary Excerpt: Dietary elimination can improve symptoms and endoscopic inflammation in patients with IBD. Randomized controlled trials are warranted.

Inflamm Bowel Dis , 23 (11), 2054-2060 Nov 2017
Konijeti GG et al

An Anti-Inflammatory Diet as Treatment for Inflammatory Bowel Disease: a Case Series Report (IBD-AID)

Summary Excerpt: This case series indicates potential for the IBD-AID as an adjunct dietary therapy for the treatment of IBD. A randomized clinical trial is warranted.

Nutr J. 2014 Jan 16;13:5. doi: 10.1186/1475-2891-13-5
Olendzki B et al

Nutritional Therapy in Pediatric Crohn Disease: the Specific Carbohydrate Diet. (SCD)

Summary Excerpt: This chart review suggests that the SCD and other low complex carbohydrate diets may be possible therapeutic options for pediatric Crohn disease. Further prospective studies are required to fully assess the safety and efficacy of the SCD, or any other low complex SCDs in pediatric patients with Crohn disease.

J Pediatr Gastroenterol Nutr. 2014 Jan;58(1):87-91. doi: 10.1097/MPG.0000000000000103.
Suskind DL et al

Exclusive Enteral Nutrition Provides an Effective Bridge to Safer Interval Elective Surgery for Adults With Crohn's Disease (EEN)

Summary Excerpt: Exclusive enteral nutrition frequently down-stages the need for surgery in patients presenting with stricturing or penetrating complications of Crohn's disease; it is associated with a reduction in systemic inflammation, operative times and the incidence of post-operative abscess or anastomotic leak.

Aliment Pharmacol Ther , 45 (5), 660-669 Mar 2017
Heerasing N et al

Dietary Therapy With the Crohn's Disease Exclusion Diet Is a Successful Strategy for Induction of Remission in Children and Adults Failing Biological Therapy (CDED)

Summary Excerpt: Dietary treatment combining PEN with the CDED may be a useful salvage regimen for patients failing biological therapy despite dose escalation.

J Crohns Colitis , 11 (10), 1205-1212 2017 Oct 1
Sigall-Boneh RS et al

Exclusive Enteral Nutrition Therapy in Paediatric Crohn's Disease Results in Long-term Avoidance of Corticosteroids: Results of a Propensity-score Matched Cohort Analysis (EEN)

Summary Excerpt: These findings suggest that EEN induction therapy is more effective in achieving early remission and is associated with long-term steroid avoidance without increased use of biologics or need for surgery.

J Crohns Colitis , 11 (9), 1063-1070 2017 Sep 1
Connors J et al

Polymeric Diet Alone Versus Corticosteroids in the Treatment of Active Pediatric Crohn's Disease: A Randomized Controlled Open-Label Trial (EEN)

Summary Excerpt: In children with active and recently diagnosed CD, a short course of polymeric diet is more effective than corticosteroids in inducing healing of gut inflammatory lesions.

Clin Gastroenterol Hepatol , 4 (6), 744-53 Jun 2006
Borrelli O et al

The Specific Carbohydrate Diet for Inflammatory Bowel Disease: A Case Series (SCD)

Summary Excerpt: Our survey results suggest that SCD can potentially be an effective tool in the management of some patients with IBD and specifically in patients with colonic and ileocolonic CD who made up the majority of our study group. A highly educated group of patients follow the SCD; all but one of the adults in our study had a college or graduate degree. Our results also suggest that in some patients with moderate to severe disease who follow this diet, discontinuation of immunosuppressive agents has been feasible.

J Acad Nutr Diet. 2015 Aug;115(8):1226-32. doi: 10.1016/j.jand.2015.04.016
Kakodkar S et al

Date Title Diets Authors Summary Excerpt Citation
Nov 2016 Patients Perceive Clinical Benefit with the Specific Carbohydrate Diet for Inflammatory Bowel Disease SCD Suskind DL et al Individuals perceived clinical improvement on the SCD. Four percent reported clinical remission prior to the SCD, while 33 % reported remission at 2 months after initiation of the SCD, and 42 % at both 6 and 12 months. For those reporting clinical remission, 13 % reported time to achieve remission of less than 2 weeks, 17 % reported 2 weeks to a month, 36 % reported 1-3 months, and 34 % reported greater than 3 months. For individuals who reported reaching remission, 47 % of individuals reported associated improvement in abnormal laboratory values. Dig Dis Sci. 2016 Nov;61(11):3255-3260. Epub 2016 Sep 16
Apr 2016 Specific Carbohydrate Diet for Pediatric Inflammatory Bowel Disease in Clinical Practice within an Academic IBD Center SCD Obih C et al This retrospective review provides evidence that the SCD can be integrated into a tertiary care center and may improve clinical and laboratory parameters for pediatric patients with nonstructuring, nonpenetrating CD as well as UC. Further prospective studies are needed to fully assess the safety and efficacy of the SCD in pediatric patients with IBD. Nutrition. 2016 Apr;32(4):418-25. doi: 10.1016/j.nut.2015.08.025. Epub 2015 Nov 30.
Feb 2016 Response to Strict and Liberalized Specific Carbohydrate Diet in Pediatric Crohn's Disease SCD Burgis JC et al Disease control may be attainable with the SCD in pediatric CD. Further studies are needed to assess adherence, impact on mucosal healing and growth. World J Gastroenterol. 2016 Feb 14;22(6):2111-7. doi: 10.3748/wjg.v22.i6.2111.
Aug 2015 The Specific Carbohydrate Diet for Inflammatory Bowel Disease: A Case Series SCD Kakodkar S et al Our survey results suggest that SCD can potentially be an effective tool in the management of some patients with IBD and specifically in patients with colonic and ileocolonic CD who made up the majority of our study group. A highly educated group of patients follow the SCD; all but one of the adults in our study had a college or graduate degree. Our results also suggest that in some patients with moderate to severe disease who follow this diet, discontinuation of immunosuppressive agents has been feasible. J Acad Nutr Diet. 2015 Aug;115(8):1226-32. doi: 10.1016/j.jand.2015.04.016
Aug 2015 Resolution of Severe Ulcerative Colitis with the Specific Carbohydrate Diet SCD Khandalavala BN and Nirmalraj MC Successful use of the SCD in children with UC has been documented. We describe previously unreported, highly beneficial results with both symptomatic and clinical improvement and complete remission of UC in an adult female with the SCD. Case Rep Gastroenterol. 2015 Aug 7;9(2):291-5. doi: 10.1159/000438745. eCollection 2015 May-Aug
May 2015 Efficacy of Concomitant Elemental Diet Therapy in Scheduled Infliximab Therapy in Patients With Crohn's Disease to Prevent Loss of Response EEN Kamata N et al Concomitant ED therapy is effective in maintaining scheduled IFX maintenance therapy in patients with luminal CD in order to prevent LOR. Dig Dis Sci , 60 (5), 1382-8 May 2015
Oct 2014 Clinical and Mucosal Improvement with Specific Carbohydrate Diet in Pediatric Crohn Disease SCD Cohen SA et al Clinical and mucosal improvements were seen in children with CD, who used SCD for 12 and 52 weeks. In addition, CE can monitor mucosal improvement in treatment trials for pediatric CD. Further studies are critically needed to understand the mechanisms underlying SCD's effectiveness in children with CD. J Pediatr Gastroenterol Nutr. 2014 Oct;59(4):516-21. doi: 10.1097/MPG.0000000000000449.
Aug 2014 Partial Enteral Nutrition With a Crohn's Disease Exclusion Diet Is Effective for Induction of Remission in Children and Young Adults With Crohn's Disease CDED Sigall-Boneh R et al Dietary therapy involving PEN with an exclusion diet seems to lead to high remission rates in early mild-to-moderate luminal Crohn's disease in children and young adults. Inflamm Bowel Dis , 20 (8), 1353-60 Aug 2014
Jun 2014 Analysis of Gut Microbiome and Diet Modification in Patients with Crohn's Disease SCD Walters SS et al Changes in the composition and complexity of the gut microbiome were identified in response to specialized carbohydrate diet. The SCD was associated with restructuring of the gut microbial communities. SOJ Microbiol Infect Dis. 2014;2(3):1-13. doi: 10.15226/sojmid/2/3/00122. Epub 2014 Jun 27.
Jan 2014 An Anti-Inflammatory Diet as Treatment for Inflammatory Bowel Disease: a Case Series Report IBD-AID Olendzki B et al This case series indicates potential for the IBD-AID as an adjunct dietary therapy for the treatment of IBD. A randomized clinical trial is warranted. Nutr J. 2014 Jan 16;13:5. doi: 10.1186/1475-2891-13-5
Jan 2014 Nutritional Therapy in Pediatric Crohn Disease: the Specific Carbohydrate Diet. SCD Suskind DL et al This chart review suggests that the SCD and other low complex carbohydrate diets may be possible therapeutic options for pediatric Crohn disease. Further prospective studies are required to fully assess the safety and efficacy of the SCD, or any other low complex SCDs in pediatric patients with Crohn disease. J Pediatr Gastroenterol Nutr. 2014 Jan;58(1):87-91. doi: 10.1097/MPG.0000000000000103.
May 2010 Lifestyle-related Disease in Crohn’s Disease: Relapse Prevention by a Semi-vegetarian Diet SVD Chiba M et al Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%) in the omnivorous group. Remission rate with SVD was 100% at 1 year and 92% at 2 years. SVD showed significant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003, log rank test). World J Gastroenterol . 2010 May 28;16(20):2484-95. doi: 10.3748/wjg.v16.i20.2484.

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