A case-based approach to new directions in dietary therapy of crohn’s disease: Food for thought

Arie Levine*, Wael El-Matary, Johan Van Limbergen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Recent evidence has demonstrated that Crohn’s disease may have its roots in dysbiosis of the microbiome and other environmental factors. One of the strongest risk factors linked to immune activation appears to be diet. Exclusion diets have been shown to ameliorate inflammation and induce remission in 70–80% of treatment-naïve children at disease onset, and to induce remission in patients that lose response or are refractory to currently recommended medical therapy. Recent studies have also linked dietary modulation of the microbiome with clinical remission, while reintroduction of the previous habitual diet led to reactivation of inflammation and reversion of the dysbiotic state. While dietary therapy has usually been used as a first line therapy as a bridge to immunomodulators, newer insights suggest that new treatment paradigms involving dietary therapy may allow different treatment strategies. This case-based narrative review will discuss the Crohn’s disease exclusion diet (CDED) as monotherapy, combination therapy with drugs, as a rescue therapy in refractory patients and for de-escalation from medical therapy.

Original languageEnglish
Article number880
JournalNutrients
Volume12
Issue number3
DOIs
StatePublished - Mar 2020

Funding

FundersFunder number
Jaeger foundation
Crohn's and Colitis Foundation of America
Nestlé Health Science
Children's Hospital Foundation
Children's Hospital Research Institute of Manitoba
Canadian Institutes of Health Research
Canada Research Chairs
Azrieli Foundation

    Keywords

    • Crohn’s disease
    • Crohn’s disease exclusion diet (CDED)
    • Diet
    • Inflammatory bowel disease
    • Microbiome
    • Treatment

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