Crohn's Disease: The Role of Nutrition Support

Donald R. Duerksen, MD, St. Boniface General Hospital and University of Manitoba, Winnipeg, Manitoba, Canada.

In This Article

Exclusion Diets

It has been suggested that certain dietary components may be responsible for exacerbating Crohn's disease and that the mechanism mediating the effectiveness of enteral formulas in inducing remission is therefore the elimination of the offending food component. Food intolerances have indeed been reported in approximately 50% of patients with Crohn's disease.[47,48] Although there are several European studies examining the role of elimination diets in maintaining remission in patients with treated Crohn's disease, the role of exclusion diets in maintaining remission in this setting is controversial. In the East Anglia study, for example, there was a significantly lower relapse rate at 2 years in the group of patients randomized to an elimination diet (62%) compared with patients who had been tapered off prednisone over a 12-week period (79%).[49] However, in a blinded, controlled study examining the reproducibility of symptoms in patients rechallenged with a food component they had previously been identified as being sensitive to, there was a low rate of confirmation (24%).[48]

Given the difficulty in maintaining such diets and the limited data to support their use as therapeutic regimens, we would agree with Pearson and colleagues,[48] who suggest that "food sensitivity is of insufficient importance to warrant putting all patients through elimination diets."


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