An anti-inflammatory diet for Inflammatory Bowel Disease; the IBD-AID

Abstract

Background AND Purpose: Inflammatory Bowel Disease (IBD), which includesCrohn's Disease (CD) and Ulcerative Colitis (UC), are chronic inflammatory gastrointestinaldisorders. Standard IBD treatment typically employs a combination ofanti-inflammatories, immunomodulators and biologics; however, the pharmacologicalapproach is not by itself curative. The Anti-Inflammatory Diet for IBD (IBDAID)is a nutritional regimen that has been derived from The Specific CarbohydrateDiet (SCD). The IBD-AID restricts the intake of complex carbohydrates suchas refined sugar, gluten-based grains, and certain starches from the diet. As inthe original SCD, these carbohydrates are thought to provide a substrate for proinflammatorybacteria. The IBD-AID also places strong emphasis on the ingestionof pre- and probiotics to help restore the balance of the intestinal flora. A thirdfocus of the IBD-AID is the elimination of trans-fatty acids, and a shift away fromfoods high in saturated fat and omega-6 polyunsaturated fats, with a proportionateencouragement of foods with omega-3 fatty acids.The objective was to assess the efficacy of the IBD-AID as an adjunct or alternativeto standard IBD therapy.DESCRIPTION OF THE PROJECT: A literature search for recent studies and reviewarticles was undertaken regarding diet and IBD. After IRB approval, medical records ofpatients with IBD who have used the IBD-AID to help treat their disease were retrospectivelyreviewed. Each patient's response to the diet was reviewed based on an estimatedHarvey Bradshaw Index (HBI) or Modified Truelove and Witts score (MTLWS). Results AND ConclusionS: Of 11 patients, 8 had CD, 3 had UC. The averageage was 42.2 years old (age range 19-70 years). Before the dietary intervention, 7patients (64%) had one or more drug treatment failures, meaning they had adverse sideeffects, the medication had no effect, or the medication had become ineffective. Afterusing the IBD-AID, all (100%) of the patients were able to discontinue at least one oftheir prior anti-inflammatories, immunomodulators or biologics. Additionally, all (100%)of the patients had symptom reduction including bowel frequency. The mean HBI preIBD-AID was 11 (range 1-20) and the mean follow-up score was 1.5 (range 0-3). Themean MTLWS pre- IBD-AID was 7 (range 6-8) and the mean follow-up score was 0.The average decrease in the HBI was 9.5 and the average decrease in the MTLWSwas 7.This case series indicates the potential for the IBD-AID to be used as an adjunctor alternative therapy for the treatment of IBD. Further randomized, prospectivetrials are needed. Strategies to improve palatability of and compliance with theIBD-AID are also needed.