Impact of individualized solid food based diet on disease activity and gut microbiome in patients with active Crohn’s Disease

Inflammatory Bowel Disease is a chronic immune mediated disorder characterized by relapsing and remitting course. The etiopathogenesis of IBD is complex and involves genetic, environmental, microbial and immunological factors working in tandem. Diet is the fundamental environmental factor implicated in the pathogenesis of IBD as it is intricately involved in maintaining homeostasis of the gut, preserving the gut barrier and mucosal permeability and regulating the physiological secretion of hormones in the gastrointestinal tract. Diet is also an important determinant of gut microbial composition and host immune responses. Historically, supplementation of nutrition has been an ad­junctive therapy for management of IBD. More recently how­ever, nutrition has been evaluated as a primary therapeutic option for management of IBD in the form of solid food based diet or exclusive or par­tial enteral nutrition. Studies on use of EEN in both pediatric and adult CD have shown encouraging results.  The effects of an individualized food-based diet (CD-TREAT), with similar composition to EEN, on the gut microbiome, inflammation, and clinical response were evaluated by Svolos and colleagues. They demonstrated that solid food based diet was equivalent to EEN in decreasing gut inflammation, tolerance and efficacy in patients with active CD. The current study aims to develop a nutritional therapy program for patients with Crohn’s disease.