The Effect of the Crohn's Disease Exclusion Diet on Patients With Pouch Inflammation: An Interventional Pilot Study

Isakov, Naomi Fliss; Kornblum, Jasmine; Zemel, Meir; Cohen, Nathaniel A.; Hirsch, Ayal; Maharshak, Nitsan

doi:10.1016/j.cgh.2022.03.049

Cited by 6 publications

(11 citation statements)

References 13 publications

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“…Finally, seven studies were included in the analysis. Isakov et al 18 examined the effectiveness of CDED on clinical remission in patients with pouch inflammation, which was included in the review because of the similarities between the pathogenesis of pouchitis and CD. Details on included studies and selection process are shown in the PRISMA flowchart on Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…A total of seven studies that investigated the effectiveness of CDED on CD remission were included in this systematic review. Five of these studies were conducted in Israel 10 , 12 , 14 , 18 , 19 , one in Israel and Canada, 10 and two in Poland. 20 , 21 With regard to the study design, two of these studies were RCTs 10 , 12 whereas five were prospective nonrandomized studies.…”

Section: Resultsmentioning

confidence: 99%

“… 20 , 21 With regard to the study design, two of these studies were RCTs 10 , 12 whereas five were prospective nonrandomized studies. 14 , 18 – 21 Two studies targeted children, 10 , 21 , three targeted adults. 12 , 18 , 20 Sigall et al 14 , 19 included both adults and children.…”

Section: Resultsmentioning

confidence: 99%

“… 14 , 18 – 21 Two studies targeted children, 10 , 21 , three targeted adults. 12 , 18 , 20 Sigall et al 14 , 19 included both adults and children. The seven studies involved a total of 277 patients, with sample sizes ranging from 15 to 74 patients.…”

Section: Resultsmentioning

confidence: 99%

“… 12 One study used clinical perianal disease activity index (cPDAI) and modified perianal disease activity index (mPDAI) to assess disease activity in adults with pouchitis. 18 Additionally, all studies used normalization of inflammatory markers, referred to C-reactive protein (CRP), and fecal calprotectin (FCP) level. Erythrocyte sedimentation rate (ESR) and simplified endoscopic activity score for Crohn’s disease (SES-CD) were also used as secondary outcome measures of remission.…”

Section: Resultsmentioning

confidence: 99%

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Effects of Crohn’s disease exclusion diet on remission: a systematic review

Zhu,

Lei,

Lin

2023

Therap Adv Gastroenterol

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Background: Dietary therapy may potentially reduce inflammation and promote mucosal healing in patients with Crohn’s disease and is associated with fewer side effects and lower cost compared to medical therapy. Recently the Crohn’s disease exclusion diet (CDED) has been developed to reduce exposure to individualized dietary components which negatively affect the intestine in patients with Crohn’s disease. Objectives: This systematic review aimed to explore the effectiveness of CDED in Crohn’s disease patients. Design: A systematic review Data sources and methods: A systematic search was performed on the PubMed, EBSCOhost, Cochrane library, OVID, Embase, Scopus, and CINHAL to identify relevant clinical trials published from 1 January 2014 to 31 August 2022. Results: A total of 1120 studies were identified and 7 studies were finally included in the analysis. The study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Conclusion: Our findings suggested that the use of CDED seemed to be effective for induction and maintenance of remission in children and adults with mild to moderate Crohn’s disease. However, heterogeneity and limitations existed among the studies included. Further investigation in the form of well-designed randomized clinical trials is needed to validate the present findings. Registration: PROSPERO registration number CRD42022335453.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effects of Crohn’s disease exclusion diet on remission: a systematic review

Zhu,

Lei,

Lin

2023

Therap Adv Gastroenterol

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Dietary Patterns Are Not Associated With Disease Activity Among Patients With Inflammatory Conditions of the Pouch in a Prospective Cohort

Barnes

Beniwal-Patel

Deepak

et al. 2023

Crohn's &Amp; Colitis 360

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Background Evidence-based recommendations regarding the influence of diet on inflammatory conditions of the pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are limited. Methods We analyzed dietary patterns at enrollment in a prospective registry of patients with one of four inflammatory conditions of the pouch (acute pouchitis, chronic antibiotic dependent pouchitis, chronic antibiotic refractory pouchitis, and Crohn’s disease of the pouch). We analyzed dietary intake by disease activity at enrollment and then compared dietary patterns among patients who remained in remission throughout the 12 month follow-up to those patients who experienced a disease relapse. We also compared dietary patterns among patients with inflammatory conditions of the pouch to the US Department of Agriculture (USDA) recommended daily goals. Results Among 308 patients, there were no differences in dietary patterns among patients with one of the four disease states at enrollment. Additionally, among the 102 patients in remission at baseline, there were no significant differences noted among patients who went on to experience a disease flare in the 12 months after enrollment compared to those patients who remained in remission. However, patients with inflammatory conditions of the pouch demonstrated decreased intake of several food groups and macronutrients including dairy, fruits, vegetables, whole grains, and fiber when compared to USDA recommendations. Conclusions In a prospective cohort, we demonstrated no impact of dietary patterns on disease activity. The relative deficiencies in several food groups and macronutrients among patients after IPAA indicate the potential role for targeted nutritional counseling in this population.

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The Crohn’s Disease Exclusion Diet: A Comprehensive Review of Evidence, Implementation Strategies, Practical Guidance, and Future Directions

Sigall Boneh,

Westoby,

Oseran

et al. 2023

Inflammatory Bowel Diseases

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Dietary therapy is increasingly recognized for the management of Crohn’s disease (CD) over recent years, including the use of exclusive enteral nutrition (EEN) as first-line therapy for pediatric CD according to current guidelines. The Crohn’s disease exclusion diet (CDED) is a whole-food diet designed to reduce exposure to dietary components that are potentially pro-inflammatory, mediated by negative effects on the gut microbiota, immune response, and the intestinal barrier. The CDED has emerged as a valid alternative to EEN with cumulative evidence, including randomized controlled trials, supporting use for induction of remission and possibly maintenance in children and adults. We gathered a group of multidisciplinary experts, including pediatric and adult gastroenterologists, inflammatory bowel diseases (IBD) expert dietitians, and a psychologist to discuss the evidence, identify gaps, and provide insights into improving the use of CDED based on a comprehensive review of CDED literature and professional experience. This article reviews the management of CDED in both children and adults, long-term aspects of CDED, indications and contraindications, selecting the best candidates, identifying challenges with CDED, globalization, the role of the multidisciplinary team, especially of dietitian, and future directions. We concluded that CDED is an established dietary therapy that could serve as an alternative to EEN in many pediatric and adult cases, especially with mild to moderate disease. In severe disease, complicated phenotypes, or with extraintestinal involvement, CDED should be considered on a case-by-case basis, according to physician and dietitians’ discretion. More studies are warranted to assess the efficacy of CDED in different scenarios.

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The Effect of the Crohn's Disease Exclusion Diet on Patients With Pouch Inflammation: An Interventional Pilot Study

Cited by 6 publications

References 13 publications

Effects of Crohn’s disease exclusion diet on remission: a systematic review

Effects of Crohn’s disease exclusion diet on remission: a systematic review

Dietary Patterns Are Not Associated With Disease Activity Among Patients With Inflammatory Conditions of the Pouch in a Prospective Cohort

The Crohn’s Disease Exclusion Diet: A Comprehensive Review of Evidence, Implementation Strategies, Practical Guidance, and Future Directions

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