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 Sigall-Boneh R, Pfeffer-Gik T, et al. Inflamm Bowel Dis 2014;20:1353–1360
In this article a team from Israel describe a restriction diet that has been used in a small number of patients with Crohn’s disease. The records of 47 patients (34 children) who had tried this diet between May 2011 and December 2013 were included in the report. Patients were receiving this treatment either as their own choice (14 patients) or because standard treatment had not worked (33 patients). Most patients had mild to moderate disease.
The diet was very restrictive. Every day half of the nutrition was from a polymeric formula such as Modulen and the other half was food but excluding, gluten, dairy products, gluten-free baked goods and breads, animal fat, processed meats, products containing emulsifiers, canned goods, and all packaged products with a due date. This diet lasted for 6 weeks. In addition every patient was on an immunomodulator drug such as azathioprine.
Roughly 70% of patients entered disease remission and most patients showed some clinical improvement. Patients did best if they had mild disease. There are some strong limitations to this report. This is not a properly designed research trial so it is not clear how much of the effect is due to the diet and how much due to the immunomodulator drug. At the moment this report does not give clear evidence of a diet that may help manage Crohn’s disease. The impact of this diet on long term nutrition and its effects are not known. However, it does raise some interesting questions about how we should manage nutrition and diet in patients with Crohn’s disease and will hopefully stimulate some further research.