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Clinical and Histologic Remission in an Adult Crohn's Disease Patient Following the Specific Carbohydrate Diet and Its Impact on Healthcare Costs.

Cureus
February 1, 2022
Ali Arjomand et al. (2 authors)
Case ReportsJournal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the clinical and economic benefits of the Specific Carbohydrate Diet (SCD) in an adult male with complicated Crohn's disease non-responsive to medical management.

Results Summary

The patient maintained the SCD for 42 months, achieving asymptomatic status, normalized fecal calprotectin levels, and resolution of inflammation on endoscopy and MRE. Healthcare costs decreased by 94% for insurance and 91% for out-of-pocket expenses.

Population

Adult male with complicated Crohn's disease non-responsive to medical management.

Effective Dosage

Not specified

Duration

42 months

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
specific carbohydrate diet (SCD)
no change
diet tolerance
adult male with complicated Crohn's disease
-
tolerated well
#1
specific carbohydrate diet (SCD)
decrease
disease symptoms
adult male with complicated Crohn's disease
40 months
has been asymptomatic
#2
specific carbohydrate diet (SCD)
decrease
stool fecal calprotectin (FCP)
adult male with complicated Crohn's disease
from 493 ug/g at baseline to 70 ug/g at month three
decreased
#3
specific carbohydrate diet (SCD)
no change
stool fecal calprotectin (FCP)
adult male with complicated Crohn's disease
-
remained in the normal range
#4
specific carbohydrate diet (SCD)
no change
histology in the colon and terminal ileum
adult male with complicated Crohn's disease
-
showed normal histology
#5
specific carbohydrate diet (SCD)
decrease
prior jejunal inflammation
adult male with complicated Crohn's disease
-
showed resolution
#6
specific carbohydrate diet (SCD)
decrease
healthcare insurance costs
adult male with complicated Crohn's disease
94%
reduction
#7
specific carbohydrate diet (SCD)
decrease
out-of-pocket patient expenses
adult male with complicated Crohn's disease
91%
reduction
#8
Abstract

Crohn's disease (CD) is an immune-mediated inflammatory disorder of the gastrointestinal tract. While the etiology is not fully elucidated, the intestinal microbiome is believed to initiate and maintain immune activation in CD. The intestinal microbiome is highly responsive to its environment, including host dietary patterns. As such, dietary interventions have the potential to modulate intestinal microbiome composition and function and improve disease outcomes. We present a retrospective chart review of an adult male with complicated Crohn's disease who was non-responsive to medical management. The patient began the specific carbohydrate diet (SCD) in February 2017 and maintained it for 42 months. The patient tolerated the SCD well and has been asymptomatic for 40 months on the SCD. Stool fecal calprotectin (FCP) decreased from 493 ug/g at baseline to 70 ug/g at month three and remained in the normal range thereafter. Endoscopy with biopsy at month 12 showed normal histology in the colon and terminal ileum. Magnetic resonance enterography (MRE) showed resolution of prior jejunal inflammation. Inflammatory bowel disease (IBD) associated healthcare costs were $42,688 in the 12 months preceding the intervention and $2,797/year with SCD. This represented a 94% reduction in healthcare insurance costs and a 91% reduction in out-of-pocket patient expenses. This case highlights the rapid and sustainable benefits of the SCD intervention in Crohn's disease from both a clinical and economic standpoint.

Study Links
Quality Scores
Safety90
Efficacy85/10
Quality60/10
Citation Metrics
Total Citations2
Citations/Year0.7
Relative Citation Ratio0.26
NIH Percentile13.5%
Research Impact Scores
APT Score0.05
Weight Score2.00
Normalized Score0.82