Crohn's Disease

Standard care for Crohn's Disease

Crohn’s is classified as an irritable bowel disease. Conventional management is aimed at reducing inflammation and maintaining remission. It usually involves drugs or surgery and is not considered curative. Surgery usually involves removing inflamed portions of the GI tract. Anti-diarrheal and pain medications may be used in some cases. Non-steroidal anti-inflammatory drugs, like prednisone, are the most common types of drugs used to treat Crohn’s.¹ Immunosuppressants, including Adalimumab (Humira™), may be used in severe cases.²

Elemental diet for dietary management of Crohn's Disease

Key features in the Physician’s Elemental Diet™ formulation provide complete nutrition in an easily assimilated form that allow the gut to rest and recuperate while patients regain comfort and control. Elemental diets that contain 100% free amino acids are thought to work in multiple ways to assist in the nutritional management of Crohn’s disease. Among the proposed mechanisms of action, elemental diets are thought to reduce the work of digestion, lower dietary antigens, decrease abnormal gut permeability, and beneficially alter the intestinal microbiome.³ Reduction of inflammatory cytokines is another major mechanism by which elemental diets helps control Crohn’s disease.⁴

Clinical studies using elemental diets for dietary management of Crohn's Disease

Research has shown that elemental diets can be effective in the nutritional management of Crohn’s disease. In one controlled clinical study, 28 patients with active Crohn’s were placed on an elemental diet for four weeks with no other food or medication. Clinical remission was achieved in 71% of cases. Intestinal biopsies also showed reduced production of inflammatory cytokines and a corrected balance between pro- and anti-inflammatory cytokine levels from the elemental diet.⁵
A randomized controlled trial comparing the effectiveness of corticosteroids and an elemental diet over periods of four and 12 weeks in 21 patients acutely ill with exacerbations of Crohn’s found that patients treated with the elemental diet had improved as much as and by some criteria more than the steroid treated group.⁶ Similarly, another randomized controlled study found that an elemental diet was at least as effective as corticosteroid drug treatment over a period of four weeks in 42 patients with active Crohn’s disease.⁷

Diagnosis & Testing

References

1. Feldman, P., Wolfson, D., Barkin, J. (2007) Medical management of Crohn’s disease. Clin Colon Rectal Surg: 269-281.
2. Mayo Clinic. “Inflammatory Bowel Disease: Diagnosis & Treatment.” March 2020. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/diagnosis-treatment/drc-20353320
3. Ciampa, B., Ramos, E., Borum, M. (2017) The emerging therapeutic role of medical foods for gastrointestinal disorders. Gastroenterol Hepatol: 104-115.
4. Ciampa, B., Ramos, E., Borum, M. (2017) The emerging therapeutic role of medical foods for gastrointestinal disorders. Gastroenterol Hepatol: 104-115.
5. Yamamoto, T., Nakahigashi, M., Umegae, S., Kitagawa, T. and Matsumoto, K. (2005) Impact of elemental diet on mucosal inflammation in patients with active Crohn's disease: Cytokine production and endoscopic and histological findings. Inflamm Bowel Dis, 11: 580-588
6. O’Morain, C., Segal, AW., Levi, AJ. (1984) Elemental diet as primary treatment of acute Crohn’s disease: a controlled trial. Br Med J (Clin Res Ed). 1859-62.
7. Gorard, DA., Hunt, JB., Payne-James, JJ. Et al. (1993) Initial response and subsequent course of Crohn’s disease treated with elemental diet or prednisone. Gut. 1198-202.
8. Mayo Clinic. “Inflammatory Bowel Disease: Diagnosis & Treatment.” March 2020. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/diagnosis-treatment/drc-20353320