Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

Traditional IBD treatments focus on altering immunological function with minimal investigation on the microbiome and intestinal barrier function.

According to a study published last week Nutrients, researchers investigated the efficacy of 3 versions of the specific carbohydrate diet (SCD) in active Crohn’s disease. The SCD was created by Sydney Haas MD, a pediatrician, to treat celiac disease. This diet eliminates all grains, sugars (except honey), all milk products (except for hard cheeses and fermented yogurt) and most processed foods.

This was a single center, double-blind study in 10 pediatric patients with mild to moderate Crohn’s disease between the ages of 7 to 18. Each Patient was randomized to either the SCD, a modified SCD including both oats and rice, or a whole foods diet. Patients were evaluated at baseline, 2, 4, 8 and at 12 weeks. Assessments included the Pediatric Crohn’s Disease Activity Index (PCDAI), CBC, C-reactive protein, ESR, albumin, stool testing, and multi-omics analysis. For the first 2 weeks, all patients went on a strict SCD after and were placed onto their randomized diet. Each Patient received nutritional counseling by a dietitian. Before each visit, patients completed a 3-day food diary to ensure compliance to the diet. Patient meals were provided and prepared by a study chef. Also, patients received a list of SCD allowed foods during the study.

As a results, at twelve weeks all of the participants achieved clinical remission. C-reactive protein levels significantly decreased in all three groups. In addition, the microbiome composition shifted in every patient over the twelve-week period. These results emphasize the significant impact diet and nutrient play in Crohn’s disease. Each diet had a significant effect on disease severity as well as on inflammatory biomarkers. The more restrictive diets were associated with the largest reductions in inflammation.

For additional support, high dose probiotics, fish oil, curcumin, glutamine, and mucilaginous botanicals can be helpful in immunomodulation and for their anti-inflammatory properties. Other common insufficiencies include magnesium, vitamin D, and iron.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Suskind D, Lee D, et al. The Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn’s Disease: A Randomized Diet Controlled Trial. Nutrients 6 December 2020, 12(12), 3729

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