CDED diet in induction therapy of Crohn’s disease

Czech version

Authors: Mitrová K.
Authors‘ workplace: Klinické a výzkumní centrum pro střevní záněty ISCARE I. V. F. a. s., Praha ; Pediatrická klinika 2. LF UK a FN Motol, Praha
Published in: Gastroent Hepatol 2019; 73(6): 476-480
Category:
doi: https://doi.org/10.14735/amgh2019476

Overview

The incidence of inflammatory bowel disease (IBD) is increasing. Despite its exact etiopathogenetic mechanism being presently unknown, both genetic and environmental factors are clearly involved.The microbiome and increased intestinal permeability may be important in the development of IBD. Changes in diet and industrial food processing may alter the microbiome and damage intestinal mucosal barrier function, leading to a pathological immune response to intestinal antigens. The hypothesis, that diet plays an important role in the pathogenesis of Crohn’s disease (CD) is supported by findings showing that exclusive enteral nutrition (EEV), with the complete exclusion of a normal diet, leads to healing of the mucosa and remission of the disease. Efforts to find a diet that could cause changes to the mucosa comparable to those of EEV led to the creation of a special elimination diet, the Crohn’s disease exclusion diet (CDED).

Submitted: 19. 11. 2019

Accepted: 3. 12. 2019

Conflict of Interest: The author declares that the article/ manuscript complies with ethical standards, patient anonymity has been respected, and she states that she has no financial, advisory or other commercial interests in relation to the subject matter.

Publication Ethics: This article/ manuscript has not been published or is currently being submitted for another review. The author agrees to publish her name and e-mail in the published article/ manuscript.

Dedication: The article/ manuscript is not supported by a grant nor has it been created with the support of any company.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio medical papers.

Keywords:

Diet – Crohn’s disease – Microbiome – enteral nutrition

Sources

1. Ng SC, Shi HY, Hamidi N et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 2018; 390 (10114): 2769–2778. doi: 10.1016/S0140-6736 (17) 32448-0.

2. Benchimol EI, Mack DR, Guttmann A et al. Inflammatory bowel disease in immigrants to Canada and their children: a population-based cohort study. Am J Gastroenterol 2015; 110 (4): 553–563. doi: 10.1038/ajg.2015.52.

3. Levine A, Wine E. Effects of enteral nutrition on Crohn’s disease: clues to the impact of diet on disease pathogenesis. Inflamm Bowel Dis 2013; 19 (6): 1322–1329. doi: 10.1097/MIB.0b013e3182802acc.

4. Narula N, Dhillon A, Zhang D et al. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2018; 4: CD000542. doi: 10.1002/14651858.CD000542.pub3.

5. Connors J, Basseri S, Grant A et al. Exclusive enteral nutrition therapy in paediatric Crohn’s disease results in long-term avoidance of corticosteroids: results of a propensity-score matched cohort analysis. J Crohns Colitis 2017; 11 (9): 1063–1070. doi: 10.1093/ecco-jcc/ jjx060.

6. Adamcová M, Bajer M, Bajerová K et al. Doporučení Pracovní skupiny dětské gastroenterologie a výživy ČPS pro diagnostiku a léčbu nespecifických střevních zánětů u dětí. Čes_slov pediat 2012; 67 (Suppl 2): 5–47.

7. Bronský J, Beránková K, Černá Z et al. Doporučení Pracovní skupiny dětské gastroenterologie a výživy ČPS pro diagnostiku a léčbu idiopatických střevních zánětů u dětí – doplněk k 1. vydání. Gastroent Hepatol 2017; 71 (1): 11–18. doi: 10.14735/amgh201711.

8. Ruemmele FM, Veres G, Kolho KL et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis 2014; 8 (10): 1179–1207. doi: 10.1016/j.crohns.2014.04.005.

9. Johnson T, Macdonald S, Hill SM et al. Treatment of active Crohn’s disease in children using partial enteral nutrition with liquid formula a randomised controlled trial. Gut 2006; 55 (3): 356–361. doi: 10.1136/gut.2004.062 554.

10. Levine A, Sigall Boneh R, Wine E. Evolving role of diet in the pathogenesis and treatment of inflammatory bowel diseases. Gut 2018; 67 (9): 1726–1738. doi: 10.1136/gutjnl-2017-315 866.

11. Takahashi K, Nishida A, Fujimoto T et al. Reduced abundance of butyrate producing bacteria species in the fecal microbial community in Crohn’s disease. Digestion 2016; 93 (1): 59–65. doi: 10.1159/000441768.

12. Furusawa Y, Obata Y, Fukuda S et al. Commensal microbe-derived butyrate induces the differentiation of colonic regulatory T cells. Nature 2013; 504 (7480): 446–450. doi: 10.1038/nature12721.

13. Wang H, Shi P, Zuo L et al. Dietary non-digestible polysaccharides ameliorate intestinal epithelial barrier dysfunction in IL-10 Knockout Mice. J Crohns Col 2016; 10 (9): 1076–1086. doi: 10.1093/ecco-jcc/jjw065.

14. Sigall Boneh R, Sarbagili Shabat C, Yanai H et al. Dietary therapy with the Crohn’s disease exclusion diet is a successful strategy for induction of remission in children and adults failing biological therapy. J Crohns Colitis 2017; 11 (10): 1205–1212. doi: 10.1093/ecco-jcc/jjx 071.

15. Sigall-Boneh R, Pfeffer-Gik T, Segal I et al. Partial enteral nutrition with a Crohn’s disease exclusion diet is effective for induction of remission in children and young adults with Crohn’s disease. Inflamm Bowel Dis 2014; 20 (8): 1353–1360. doi: 10.1097/MIB.0000000000000 110.

16. Levine A, Wine E, Assa A et al. Crohn’s disease exclusion diet plus partial enteral nutrition induces sustained remission in a randomized controlled trial. Gastroenterology 2019; 157 (2): 440–450 e8. doi: 10.1053/j.gastro.2019.04. 021.

17. Bronský J, Frühauf P, Hradský O et al. Stanovisko Pracovní skupiny pro dětskou gastroenterologii, hepatologii a výživu České pediatrické společnosti (PSDG ČPS) k používání dietních opatření v léčbě Crohnovy nemoci u dětských pacientů. Gastoent Hepatol 2019; 73 (6): 472–476. doi: 10.14735/amgh2019472.