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

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 i...

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Autores principales: Levine, Arie, El-Matary, Wael, Van Limbergen, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146196/
https://www.ncbi.nlm.nih.gov/pubmed/32214055
http://dx.doi.org/10.3390/nu12030880
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author Levine, Arie
El-Matary, Wael
Van Limbergen, Johan
author_facet Levine, Arie
El-Matary, Wael
Van Limbergen, Johan
author_sort Levine, Arie
collection PubMed
description 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.
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spelling pubmed-71461962020-04-15 A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought Levine, Arie El-Matary, Wael Van Limbergen, Johan Nutrients Concept Paper 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. MDPI 2020-03-24 /pmc/articles/PMC7146196/ /pubmed/32214055 http://dx.doi.org/10.3390/nu12030880 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Concept Paper
Levine, Arie
El-Matary, Wael
Van Limbergen, Johan
A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought
title A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought
title_full A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought
title_fullStr A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought
title_full_unstemmed A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought
title_short A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought
title_sort case-based approach to new directions in dietary therapy of crohn’s disease: food for thought
topic Concept Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146196/
https://www.ncbi.nlm.nih.gov/pubmed/32214055
http://dx.doi.org/10.3390/nu12030880
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