Exclusive enteral nutrition (EEN) is a first-line treatment in active, mild to moderate Crohn’s disease (CD) in children. The Crohn’s disease exclusion diet (CDED), which avoids products known to have a pro-inflammatory effect on the intestinal mucosa, presents similar effectiveness to EEN for inducing remission in the paediatric population. The aim of the study was to evaluate the effectiveness of the CDED in inducing remission in adult patients. Between March 2020 and May 2021, 32 patients in a gastroenterology outpatient centre were treated according to the assumptions of the CDED. The patients were seen at baseline, at week 6, and at week 12 of the study. During the visits, anthropometric measurements and laboratory tests were performed, Crohn’s disease activity index (CDAI) was calculated, and the Inflammatory Bowel Disease Questionnaire (IBDQ) was completed. The study included a total of 32 participants, 18 women (56.3%) and 14 men (43.7%). Clinical remission was obtained in 76.7% patients after 6 weeks and in 82.1% after 12 weeks of therapy. Calprotectin levels were significantly lower in the second follow-up compared with baseline (p = 0.021). The CDED is an effective therapy for inducing remission in the adult CD population.

Diet plays an important role in the pathogenesis of inflammatory bowel disease. It has an impact on microbiome, host barrier, and immune response. Clinical studies indicate that various dietary interventions such as exclusive enteral nutrition and exclusion diets might be useful for induction of remission in mild to moderate Crohn's disease, but also for patients failing biological therapy. Current treatment strategies try to solve the problem of poor patient compliance due to the required strict dietary regime. The number of adverse events associated with the use of dietary alternatives is incomparable with the side effects of glucocorticosteroids or biological treatment, which makes them a tempting therapeutic option.

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