A Crohn's-specific exclusion diet in children
Research type
Research Study
Full title
Assessing the gut microbiome in children with Crohn's disease: Effects of a specific exclusion diet.
IRAS ID
170318
Contact name
Jenny Epstein
Contact email
Sponsor organisation
Chelsea and Westminster Hospital NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Crohn's disease (CD) is a debilitating inflammatory bowel disease (IBD) causing pain, diarrhoea, bleeding and poor growth. It is a lifelong diagnosis with no cure. Treament is with immune suppressing drugs which have serious side effects. The cause is unknown, although people with CD have very different gut bacteria to healthy people.
Exclusive enteral nutrition (EEN) is standard first line treatment for children with CD. This is a 'milkshake' taken for 6 weeks with no solid food. It is effective and although we do not know how it works, it is known to change gut bacteria. Disease relapse following resumption of normal diet is near universal. Partial enteral nutrition (PEN) (ie 1-2 cups of milkshake/day) accompanied by normal diet is ineffective.
Recently however investigators have shown that PEN accompanied by a specific exclusion diet, does work. Such a diet would be (a) easier to tolerate than EEN and (b) possible to maintain in the longer term, potentially reducing the need for higher toxicity drug treatments.
Children with newly diagnosed CD will be offered a standard 6 week course of EEN. Then they will be offered the choice between classical food reintroduction to all inclusive diet, or a specific CD exclusion diet alongside PEN. All other aspects of CD management will proceed as normal and all children will be supervised by a specialist Paediatric Dietician.
Stool samples for bacterial analysis will be obtained at diagnosis, during week 1
of EEN, during week 6 of EEN, during week 1 of food re-introduction and at subsequent outpatient visits.Detailed dietary histories will be recorded, as well as accepted anthropometric, serological and faecal markers of disease activity. On average 20 - 30 children present to our unit with new diagnosis of CD each year. All will be invited to participate over the 2 year study period.
REC name
Wales REC 7
REC reference
15/WA/0026
Date of REC Opinion
28 Jan 2015
REC opinion
Favourable Opinion