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Open AccessConcept Paper

A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought

1
Wolfson Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Holon 5822012, Tel Aviv, Israel
2
Section of Pediatric Gastroenterology & Nutrition, University of Manitoba, Winnipeg, MB R3E 0Z2, Canada
3
Amsterdam University Medical Centres, Emma Children’s Hospital, 1105 AZ Amsterdam, The Netherlands
4
Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology and Metabolism, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(3), 880; https://doi.org/10.3390/nu12030880
Received: 10 March 2020 / Revised: 22 March 2020 / Accepted: 23 March 2020 / Published: 24 March 2020
Recent evidence has demonstrated that Crohn’s disease may have its roots in dysbiosis of the microbiome and other environmental factors. One of the strongest risk factors linked to immune activation appears to be diet. Exclusion diets have been shown to ameliorate inflammation and induce remission in 70–80% of treatment-naïve children at disease onset, and to induce remission in patients that lose response or are refractory to currently recommended medical therapy. Recent studies have also linked dietary modulation of the microbiome with clinical remission, while reintroduction of the previous habitual diet led to reactivation of inflammation and reversion of the dysbiotic state. While dietary therapy has usually been used as a first line therapy as a bridge to immunomodulators, newer insights suggest that new treatment paradigms involving dietary therapy may allow different treatment strategies. This case-based narrative review will discuss the Crohn’s disease exclusion diet (CDED) as monotherapy, combination therapy with drugs, as a rescue therapy in refractory patients and for de-escalation from medical therapy. View Full-Text
Keywords: Crohn’s disease; microbiome; treatment; inflammatory bowel disease; diet; Crohn’s disease exclusion diet (CDED) Crohn’s disease; microbiome; treatment; inflammatory bowel disease; diet; Crohn’s disease exclusion diet (CDED)
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Levine, A.; El-Matary, W.; Van Limbergen, J. A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought. Nutrients 2020, 12, 880.

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