Persistent symptoms in patients with Crohn's disease in remission: An exploratory study on the role of diet

Scand J Gastroenterol. 2018 May;53(5):573-578. doi: 10.1080/00365521.2017.1397736. Epub 2017 Nov 23.

Abstract

Objectives: Patients with Crohn's disease (CD) often report food hypersensitivities with gastrointestinal (GI) symptoms despite being in clinical remission. We aimed to identify the most frequent symptoms and dietary triggers in such patients, and also explored whether a strict elimination diet may reduce their GI symptoms.

Methods: We assessed GI symptoms and dietary triggers in 16 patients with CD in clinical remission. Of these, 12 patients subsequently participated in a dietary intervention trial: two weeks on a habitual diet including wheat and dairy products followed by two weeks of a strict elimination diet. The severity of seven symptoms (overall symptoms, abdominal pain, bloating, abnormal feces, wind, fatigue, and musculoskeletal pain) was measured by using visual analog scales throughout the four weeks intervention period.

Main results: The most common symptoms were abdominal pain, wind, bloating, odorous wind/feces, and diarrhea. Dairy and wheat products were reported as the most frequent dietary symptom triggers. All symptoms improved (p < .05) during the elimination diet period, especially in patients with small intestinal affection.

Conclusion: Our exploratory study suggests that dietary interventions such as an elimination diet may reduce GI symptoms in patients with CD in remission.

Keywords: Elimination diet; FODMAP; functional gastrointestinal disorders; inflammatory bowel disease; irritable bowel syndrome.

MeSH terms

  • Adult
  • Aged
  • Crohn Disease / diet therapy*
  • Crohn Disease / physiopathology*
  • Diet*
  • Female
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / diet therapy*
  • Food Preferences
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Remission Induction
  • Visual Analog Scale
  • Young Adult