Randomised Clinical Trial: Exclusive Enteral Nutrition Versus Standard of Care for Acute Severe Ulcerative Colitis
EEN
Patients on EEN had a shorter hospital stay [median (range) 10 (8-17) vs 13 (8-24) days; P = 0.04], higher day 7 albumin level (34 ± 4 vs 29 ± 3 g/L, P < 0.01), greater reduction in serum C-reactive protein and faecal calprotectin levels (both P = 0.04) and a lower composite outcome of colectomy/hospitalisation at 6 months (16% vs 39%; P = 0.045) compared to SOC.
Aliment Pharmacol Ther . 2021 Jan 13. doi: 10.1111/apt.16249
Authors: Sahu P et al
Dietary Therapies Induce Rapid Response and Remission in Pediatric Patients With Active Crohn's Disease
CDED,
EEN
For pediatric patients with active CD, dietary therapies (CDED and EEN) induce a rapid clinical response (by week 3). Identification of patients with and without a rapid response to diet might help identify those who, with compliance, will be in clinical remission by week 6 of the diet.
Clin Gastroenterol Hepatol . 2020 Apr 14;S1542-3565(20)30487-0. doi: 10.1016/j.cgh.2020.04.006.
Authors: Sigall Boneh R et al
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
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
Authors: Sigall-Boneh R 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
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
Authors: Sigall-Boneh RS et al
Effectiveness of Mediterranean Diet's Adherence in children with Inflammatory Bowel Diseases
MD
Children with IBD in remission have a sub-optimal food intake compared to HCs. MD seems to correlate to decreased intestinal inflammation.
Nutrients . 2020 Oct 20;12(10):3206. doi: 10.3390/nu12103206.
Authors: Strisciuglio C et al
The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn's Disease: A Randomized Diet Controlled Trial
SCD,
mSCD
This study emphasizes the impact of diet in CD. Each diet had a positive effect on symptoms and inflammatory burden; the more exclusionary diets were associated with a better resolution of inflammation.
Nutrients . 2020 Dec 6;12(12):E3749. doi: 10.3390/nu12123749
Authors: Suskind DL et al
Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease
SCD
SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD.
J Clin Gastroenterol. 2018 Feb;52(2):155-163. doi: 10.1097/MCG.0000000000000772.
Authors: Suskind DL et al
Patients Perceive Clinical Benefit with the Specific Carbohydrate Diet for Inflammatory Bowel Disease
SCD
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
Authors: Suskind DL et al
Nutritional Therapy in Pediatric Crohn Disease: the Specific Carbohydrate Diet.
SCD
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.
Authors: Suskind DL et al
Treatment of Active Crohn's Disease With an Ordinary Food-based Diet That Replicates Exclusive Enteral Nutrition
CD-TREAT
CD-TREAT replicates EEN changes in the microbiome, decreases gut inflammation, is well tolerated, and is potentially effective in patients with active CD.
Gastroenterology . 2019 Apr;156(5):1354-1367.e6. doi: 10.1053/j.gastro.2018.12.002. Epub 2018 Dec 11.
Authors: Svolos V et al
Lack of Mucosal Healing From Modified Specific Carbohydrate Diet in Pediatric Patients With Crohn Disease
mSCD
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.
Authors: Wahbeh GT et al
Analysis of Gut Microbiome and Diet Modification in Patients with Crohn's Disease
SCD
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.
Authors: Walters SS et al
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.
