Nutritional Management of Paediatric Crohn’s Disease

Abstract

For many people with Crohn’s disease (CD), onset occurs in childhood or adolescence. Treatment for CD has moved from predominantly surgical to, more often, pharmacological. While successful for many, others have tried various medications and combinations without long-term success and, for all, drug treatment needs to be balanced with potential therapy risks. Findings that diet can impact pathogenesis of CD to cause and exacerbate symptoms have inspired studies of dietary interventions. The Crohn’s Disease Exclusion Diet (CDED) was developed following the observation that certain dietary components were linked to inflammation and gut dysbiosis found in those with CD. This three-phase diet included two periods of a highly-controlled and prescribed diet, followed by a maintenance diet in which patients had a wider choice of foods. The diet limited ingestion of foods that may trigger inflammation and/or dysbiosis in CD, such as saturated fats, wheat, carrageenan, and some dairy products, and included healthy choices, such as fruits, vegetables, lean protein sources, and complex carbohydrates. It was nutritionally balanced, science-based, and included foods that were widely accessible. Based on findings from clinical trials and case studies, four experts (Prof Lionetti, Prof Martín-de-Carpi, Mrs Sigall-Boneh, and Prof Wine) discussed the background of CD, current treatment options, the utility of dietary therapies including CDED, and how all healthcare professionals (HCP) looking after children and adolescents with CD should consider the use of diet as part of their therapy.