Crohn's Disease Exclusion Diet for the Treatment of Crohn's Disease: Real-World Experience from a Tertiary Center

Naomi Fliss-Isakov; Nathaniel Aviv Cohen; Ahuva Bromberg; Gal Elbert; Ronit Anbar; Yulia Ron; Ayal Hirsch; Tamar Thurm; Nitsan Maharshak

doi:10.3390/jcm12165428

Crohn's Disease Exclusion Diet for the Treatment of Crohn's Disease: Real-World Experience from a Tertiary Center

J Clin Med. 2023 Aug 21;12(16):5428. doi: 10.3390/jcm12165428.

Authors

Naomi Fliss-Isakov^{1

2}, Nathaniel Aviv Cohen^{1

2}, Ahuva Bromberg^{2

3}, Gal Elbert³, Ronit Anbar³, Yulia Ron^{1

2}, Ayal Hirsch^{1

2}, Tamar Thurm^{1

2}, Nitsan Maharshak^{1

2}

Affiliations

¹ Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
² Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Tel Aviv 6423906, Israel.
³ Nutrition and Dietetics Department, Tel Aviv Medical Center, Tel Aviv 6423906, Israel.

Abstract

The Crohn's Disease (CD) exclusion diet (CDED) has been shown to induce remission in pediatric and adult patients with CD. In this retrospective cohort study, we describe our real-world experience with the CDED at the inflammatory bowel disease (IBD) unit of the Tel Aviv Medical Center between 2018-2021. CD patients with multiple clinical presentations and disease phenotypes who initiated the diet were included. Indications for treatment, medical and nutritional data were collected from dietician clinic visits and medical records. Clinical and biomarker responses were determined. The CDED was recommended to 220 CD patients. Seventy-two patients were included in the analysis for a clinically active disease (n = 48) or for remission maintenance (n = 24). Among patients with a clinically active disease, 62.5% of patients achieved clinical remission at week 6 and at week 12. A positive association between high adherence to the CDED and clinical remission at week 12 was observed (adjusted OR = 7.6, 95% CI 1.07-55.2, p = 0.043). Among patients treated for remission maintenance, remission at week 12 was maintained among 83.3% of patients. We conclude that the CDED may be a promising intervention for multiple CD presentations and indications. These findings should be further validated in larger, prospective, controlled studies.

Keywords: Crohn’s disease; dietary therapy; exclusion diet.

Grants and funding

The publication of this investigator-initiated study was supported by an educational grant from Nestlé. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.