Ingested matter affects intestinal lesions in Crohn's disease

Area of Science:

• Gastroenterology
• Immunology
• Nutritional Science

Background:

• Modern Western lifestyle factors may trigger Crohn's disease (CD) in susceptible individuals.
• Ingested matter is a potential environmental factor contributing to persistent intestinal lesions in CD.

Purpose of the Study:

• To investigate if excluding specific ingested matter can improve intestinal Crohn's lesions.
• To assess the efficacy of a highly restricted diet in managing CD.

Main Methods:

• A pilot study used a restricted diet (spelt bread, red meat) in 5 CD patients.
• A controlled trial randomized 18 mild-to-moderate CD patients to an active or control diet.
• Mucosal healing was assessed via MRI, endoscopy, and sonography; CDAI and IBDQ were secondary endpoints.

Main Results:

• Four of five pilot patients showed significant improvement within 4 weeks.
• In the controlled trial, 3/4 assessable patients on the active diet showed improvement (vs. 1/9 controls) by MRI/endoscopy (P=0.027).
• Sonography also showed significant improvement in the active group (P=0.016), though CDAI/IBDQ scores improved similarly in both groups.

Conclusions:

• Ingested matter, influenced by Western lifestyle, may perpetuate intestinal Crohn's lesions.
• A restricted diet shows potential for improving intestinal lesions in Crohn's disease patients.