Abstract
It has been claimed that prolonged remissions of Crohn's disease can be achieved after enteral or parenteral nutrition, by identifying and excluding foods that exacerbate a patient's symptoms. The occurrence of food intolerances were assessed after induction of remission with elemental diet in 42 eligible patients to whom single foods were introduced over five days. Suspect foods were reinvestigated with open and if possible, double blind rechallenge. Fourteen patients (33%) dropped out of the study because of relapse of disease unrelated to food (n = 8) or because of difficulties in complying with the regimen (n = 6). Twenty (48%) of the patients identified food sensitivities whereas eight (19%) did not. Seventeen of the patients who identified food sensitivities had an open rechallenge with recurrence of symptoms in 10 (24% of total). Food sensitivity was confirmed in three patients on double blind challenge. There was no significant difference in the duration of remission between patients who did or did not identify food sensitivities. During the study three cases of intolerance to the formula diet, and one of severe salicylate sensitivity were encountered. In conclusion food sensitivities are evident after treatment of Crohn's disease with elemental diet but are variable, often do not persist, and are of insufficient importance to warrant putting all patients through elimination diets.
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Selected References
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- Giaffer M. H., Cann P., Holdsworth C. D. Long-term effects of elemental and exclusion diets for Crohn's disease. Aliment Pharmacol Ther. 1991 Apr;5(2):115–125. doi: 10.1111/j.1365-2036.1991.tb00012.x. [DOI] [PubMed] [Google Scholar]
- Ginsberg A. L., Albert M. B. Treatment of patient with severe steroid-dependent Crohn's disease with nonelemental formula diet. Identification of possible etiologic dietary factor. Dig Dis Sci. 1989 Oct;34(10):1624–1628. doi: 10.1007/BF01537124. [DOI] [PubMed] [Google Scholar]
- Jones V. A., Dickinson R. J., Workman E., Wilson A. J., Freeman A. H., Hunter J. O. Crohn's disease: maintenance of remission by diet. Lancet. 1985 Jul 27;2(8448):177–180. doi: 10.1016/s0140-6736(85)91497-7. [DOI] [PubMed] [Google Scholar]
- McCamman S., Beyer P. L., Rhodes J. B. A comparison of three defined formula diets in normal volunteers. Am J Clin Nutr. 1977 Oct;30(10):1655–1660. doi: 10.1093/ajcn/30.10.1655. [DOI] [PubMed] [Google Scholar]
- Morin C. L., Roulet M., Roy C. C., Weber A. Continuous elemental enteral alimentation in children with Crohn's disease and growth failure. Gastroenterology. 1980 Dec;79(6):1205–1210. [PubMed] [Google Scholar]
- O'Moráin C., Segal A. W., Levi A. J. Elemental diet as primary treatment of acute Crohn's disease: a controlled trial. Br Med J (Clin Res Ed) 1984 Jun 23;288(6434):1859–1862. doi: 10.1136/bmj.288.6434.1859. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Summers R. W., Switz D. M., Sessions J. T., Jr, Becktel J. M., Best W. R., Kern F., Jr, Singleton J. W. National Cooperative Crohn's Disease Study: results of drug treatment. Gastroenterology. 1979 Oct;77(4 Pt 2):847–869. [PubMed] [Google Scholar]
- Teahon K., Bjarnason I., Pearson M., Levi A. J. Ten years' experience with an elemental diet in the management of Crohn's disease. Gut. 1990 Oct;31(10):1133–1137. doi: 10.1136/gut.31.10.1133. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Workman E. M., Alun Jones V., Wilson A. J., Hunter J. O. Diet in the management of Crohn's disease. Hum Nutr Appl Nutr. 1984 Dec;38(6):469–473. [PubMed] [Google Scholar]