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

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
Dec 2017 Exclusive Enteral Nutrition versus Infliximab in Inducing Therapy of Pediatric Crohn’s Disease EEN Lou Y et al EEN provided similar improvements as IFX in clinical symptoms, mucosal healing, and BMI. EEN therapy has less adverse effects when compared with IFX. Gastroenterol Res Pract , 2017, 6595048 2017
Nov 2017 Nutritional Adequacy of the Specific Carbohydrate Diet in Pediatric Inflammatory Bowel Disease SCD Braly K et al Nutrient intake of pediatric inflammatory bowel disease patients on the SCD was adequate when compared with a healthy peer reference population, but adequacy was variable when compared with the dietary recommended intakes. Close monitoring with a multidisciplinary team for patients using the SCD as an alternative or adjunct therapy is recommend to ensure positive outcomes for overall patient health. J Pediatr Gastroenterol Nutr. 2017 Nov;65(5):533-538. doi: 10.1097/MPG.0000000000001613.
Nov 2017 Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease AIP Konijeti GG et al 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
Oct 2017 Induction with Infliximab and a Plant-Based Diet as First-Line (IPF) Therapy for Crohn Disease: A Single-Group Trial SVD Chiba M et al IPF therapy can induce remission in most patients with CD who are naïve to biologics regardless of age or whether they have a new diagnosis or relapse. Perm J . 2017;21:17-009. doi: 10.7812/TPP/17-009.
Oct 2017 Diet to the Rescue: Cessation of Pharmacotherapy After Initiation of Exclusive Enteral Nutrition (EEN) Followed by Strict and Liberalized Specific Carbohydrate Diet (SCD) in Crohn's Disease EEN, SCD Nakayuenyongsuk W et al NA Dig Dis Sci. 2017 Oct;62(10):2686-2689. doi: 10.1007/s10620-016-4446-1.
Oct 2017 Effect of the Specific Carbohydrate Diet on Inflammatory Bowel Disease: A 5-Year Longitudinal Study SCD Chutkan R et al Our data confirms that the Specific Carbohydrate Diet is an effective long-term treatment for IBD that can result in improvement of symptoms, mucosal healing, and discontinuation of biologic and immunosuppressive medications. American Journal of Gastroenterology: October 2017 - Volume 112 - Issue - p S1479
Oct 2017 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 Sigall-Boneh RS et al 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
Sep 2017 Lack of Mucosal Healing From Modified Specific Carbohydrate Diet in Pediatric Patients With Crohn Disease mSCD Wahbeh GT et al All subjects reported no active symptoms before repeat endoscopic evaluation on mSCD, the majority had consistently normal C-reactive protein, albumin and hematocrit assessments, and mildly elevated fecal calprotectin (>50 μg/g, median 201, range 65-312) at any point within 3 months before the repeat endoscopy. One patient showed complete ileocolonic healing but persistent upper gastrointestinal tract ulceration. Complete macroscopic mucosal healing of both the ileocolon and upper gastrointestinal tract was not seen in any patient. J Pediatr Gastroenterol Nutr. 2017 Sep;65(3):289-292. doi: 10.1097/MPG.0000000000001619.
Sep 2017 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 Connors J et al 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
Sep 2017 Efficacy of Exclusive Enteral Nutrition in Complicated Crohn's Disease EEN Yang Q et al EEN is effective in inducing early clinical remission, mucosal healing, promoting fistula closure and reducing the size of abscess in adult CD patients with complications. Scand J Gastroenterol , 52 (9), 995-1001 Sep 2017
Mar 2017 Exclusive Enteral Nutrition Provides an Effective Bridge to Safer Interval Elective Surgery for Adults With Crohn's Disease EEN Heerasing N et al 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
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

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