Clinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn disease.
Study Goal
The researchers aimed to evaluate clinical and mucosal responses to the Specific Carbohydrate Diet (SCD) in children with Crohn's disease (CD).
Results Summary
The study found significant improvements in clinical indices (HBI, PCDAI) and mucosal healing (LS) after 12 and 52 weeks of SCD, with sustained benefits in most patients. Two patients showed sustained mucosal healing at 52 weeks.
Population
Children with active Crohn's disease (Pediatric Crohn's Disease Activity Index ≥ 15).
Effective Dosage
Not specified (dietary intervention).
Duration
52 weeks (with primary outcomes at 12 weeks).
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
specific carbohydrate diet (SCD) | decrease | Harvey-Bradshaw Index (HBI) | children with Crohn disease (CD) | from 3.3 ± 2.0 to 0.6 ± 1.3 | significantly decreased | #1 |
specific carbohydrate diet (SCD) | decrease | Pediatric Crohn's Disease Activity Index (PCDAI) | children with Crohn disease (CD) | from 21.1 ± 5.9 to 7.8 ± 7.1 | significantly decreased | #2 |
specific carbohydrate diet (SCD) | decrease | Lewis score (LS) | children with Crohn disease (CD) | from 2153 ± 732 to 960 ± 433 | declined significantly | #3 |
specific carbohydrate diet (SCD) | decrease | Harvey-Bradshaw Index (HBI) | children with Crohn disease (CD) | 0.1 ± 0.4 at 52 weeks | remained improved | #4 |
specific carbohydrate diet (SCD) | decrease | Pediatric Crohn's Disease Activity Index (PCDAI) | children with Crohn disease (CD) | 5.4 ± 5.5 at 52 weeks | remained improved | #5 |
specific carbohydrate diet (SCD) | increase | mucosal healing | children with Crohn disease (CD) | 2 patients | showed sustained | #6 |
specific carbohydrate diet (SCD) | increase | clinical and mucosal improvements | children with Crohn disease (CD) | - | were seen | #7 |
OBJECTIVE: The aim of the study was to prospectively evaluate clinical and mucosal responses to the specific carbohydrate diet (SCD) in children with Crohn disease (CD). METHODS: Eligible patients with active CD (Pediatric Crohn's Disease Activity Index [PCDAI] ≥ 15) underwent a patency capsule and, if passed intact, capsule endoscopy (CE) was performed. Patients taking SCD were monitored for 52 weeks while maintaining all prescribed medications. Demographic, dietary, and clinical information, PCDAI, Harvey-Bradshaw Index (HBI), and Lewis score (LS) were collected at 0, 12, and 52 weeks. CEs were evaluated by an experienced reader blinded to patient clinical information and timing. RESULTS: Sixteen patients were screened; 10 enrolled; and 9 completed the initial 12-week trial-receiving 85% of estimated caloric needs before, and 101% on the SCD. HB significantly decreased from 3.3 ± 2.0 to 0.6 ± 1.3 (P = 0.007) as did PCDAI (21.1 ± 5.9 to 7.8 ± 7.1, P = 0.011). LS declined significantly from 2153 ± 732 to 960 ± 433 (P = 0.012). Seven patients continued the SCD up to 52 weeks; HB (0.1 ± 0.4) and PCDAI (5.4 ± 5.5) remained improved (P = 0.016 and 0.027 compared to baseline), with mean LS at 1046 ± 372 and 2 patients showed sustained mucosal healing. CONCLUSIONS: Clinical and mucosal improvements were seen in children with CD, who used SCD for 12 and 52 weeks. In addition, CE can monitor mucosal improvement in treatment trials for pediatric CD. Further studies are critically needed to understand the mechanisms underlying SCD's effectiveness in children with CD.