Elemental Diet Therapy Plays a Significant Role in Preventing Surgical Recurrence of Crohn's Disease in the Era of Biologics
PEN
Although univariate analyses revealed that all three treatment strategies had significant effects on surgical recurrence in patients with CD, multivariate analysis revealed that only ED therapy was significantly associated with surgical recurrence rates. Thus, ED therapy plays an important role in the management of CD, even in the era of biological therapies.
Surg Today . 2021 Feb;51(2):250-257. doi: 10.1007/s00595-020-02112-5. Epub 2020 Aug 18.
Authors: Shinozaki M et al
Exclusive Enteral Nutrition Provides an Effective Bridge to Safer Interval Elective Surgery for Adults With Crohn's Disease
EEN
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
Authors: Heerasing N 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
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
Authors: Connors J et al
Exclusive Enteral Nutrition versus Infliximab in Inducing Therapy of Pediatric Crohn’s Disease
EEN
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
Authors: Lou Y et al
Induction with Infliximab and a Plant-Based Diet as First-Line (IPF) Therapy for Crohn Disease: A Single-Group Trial
SVD
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.
Authors: Chiba M 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
Lifestyle-related Disease in Crohn’s Disease: Relapse Prevention by a Semi-vegetarian Diet
SVD
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.
Authors: Chiba M et al
Low-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative Colitis
Other Diets - UC
In a cross-over study of patients with UC in remission, we found that a catered LFD or iSAD were each well tolerated and increased quality of life. However, the LFD decreased markers of inflammation and reduced intestinal dysbiosis in fecal samples. Dietary interventions therefore might benefit patients with UC in remission.
Clin Gastroenterol Hepatol . 2021 Jun;19(6):1189-1199.e30. doi: 10.1016/j.cgh.2020.05.026. Epub 2020 May 20.
Authors: Fritsch J et al
Multidimensional Impact of Mediterranean Diet on IBD Patients
MED
A significant reduction of malnutrition-related parameters and liver steatosis was observed in both CD and UC patients after short-term dietary intervention based on the adoption of Md, and this was associated with a spontaneous improvement of disease activity and inflammatory markers.
https://pubmed.ncbi.nlm.nih.gov/32440680/
Authors: Chicco F et al
Nutritional Adequacy of the Specific Carbohydrate Diet in Pediatric Inflammatory Bowel Disease
SCD
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.
Authors: Braly K 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
Partial Enteral Nutrition Induces Clinical and Endoscopic Remission in Active Pediatric Crohn's Disease: Results of a Prospective Cohort Study
PEN
The results of our prospective pilot study suggest that PEN, allowing one meal from AID, could be as effective as EEN in inducing clinical and endoscopic remission in children with active CD. However, larger randomized controlled studies are warranted to confirm our findings.
Eur J Pediatr . 2020 Mar;179(3):431-438. doi: 10.1007/s00431-019-03520-7. Epub 2019 Nov 28.
Authors: Urlep D et al
