Creatine Supplementation for Patients with Inflammatory Bowel Diseases: A Scientific Rationale for a Clinical Trial

Area of Science:

• Biochemistry
• Gastroenterology
• Nutritional Science

Background:

• Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease, are chronic conditions with limited therapeutic options.
• Creatine monohydrate (Cr) is a cellular energy precursor with pleiotropic effects, suggesting potential anti-inflammatory properties.
• Pre-clinical data (in vitro, in vivo) and a case study indicate Cr may benefit IBD patients.

Purpose of the Study:

• To evaluate the potential of oral creatine monohydrate (Cr) supplementation as an effective therapeutic strategy for inducing remission in patients with IBD.
• To explore Cr's role in alleviating symptoms associated with ulcerative colitis and Crohn's disease.

Main Methods:

• Review of theoretical considerations, in vitro and in vivo experimental data, and a single-case pilot study.
• Analysis of ongoing pilot clinical trial (NCT02463305) using oral Cr (2x7g/day for 2 months).
• Proposal for a larger, longer-term study (2x3-5g/day for 3-6 months) to assess Cr efficacy.

Main Results:

• Theoretical and preliminary data suggest oral Cr supplementation may be beneficial for IBD.
• Cr is well-tolerated in healthy individuals and patients with neuromuscular diseases.
• Current pilot trial data will inform future, larger studies.

Conclusions:

• Oral creatine monohydrate (Cr) supplementation is a promising, well-tolerated adjuvant therapy for IBD.
• Further clinical investigation is warranted to establish Cr's efficacy in treating ulcerative colitis and Crohn's disease.
• Cr may offer a novel therapeutic avenue for managing IBD symptoms and promoting remission.