The effect of elemental diet on intestinal permeability and inflammation in Crohn's disease

Gastroenterology. 1991 Jul;101(1):84-9. doi: 10.1016/0016-5085(91)90463-u.


This study examines whether treatment of acute Crohn's disease with an elemental diet improves intestinal integrity and inflammation as assessed by a 51Cr-labeled ethylenediaminetetraacetatic acid (EDTA) permeability test and the fecal excretion of 111In-labeled autologous leukocytes, respectively. Thirty-four patients with active Crohn's disease completed a 4-week treatment course with an elemental diet. Active disease was characterized by increased intestinal permeability [24-hour urine excretion of orally administered 51Cr-EDTA, 6.4% +/- 0.6% (mean +/- SE); normal, less than 3.0%] and by high fecal excretion of 111In-labeled leukocytes (14.2% +/- 1.1%; normal, less than 1.0%). Twenty-seven (80%) went into clinical remission, usually within a week of starting treatment. After 4 weeks of treatment, there was a significant decrease in both the urine excretion of 51Cr-EDTA (to 3.4% +/- 0.5%; P less than 0.01) and the fecal excretion of 111In (to 5.7% +/- 1.0%; P less than 0.001), indicating that such treatment is not just symptomatic. A framework for the mechanism by which elemental diet works, centering around the importance of the integrity of the intestinal barrier function, is proposed, and also appears to provide a logical explanation for some relapses of the disease.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Cell Membrane Permeability
  • Chromium Radioisotopes
  • Crohn Disease / diet therapy*
  • Crohn Disease / metabolism*
  • Crohn Disease / pathology
  • Edetic Acid
  • Female
  • Food, Formulated*
  • Humans
  • Indium Radioisotopes
  • Intestinal Mucosa / metabolism*
  • Leukocytes / metabolism
  • Male
  • Middle Aged


  • Chromium Radioisotopes
  • Indium Radioisotopes
  • Edetic Acid